Association of OPRMI and CYP3A gene polymorphisms with fentanyl analgesic effect on abdominal hysterec-tomy

Abstract

Objective To discuss the influence of μ-opioid receptor （ OPRM1） and CYP3A gene polymor-phism on analgesic effect of fentanyl for abdominal hysterectomy patients .Methods 198 cases of gynecologic anes-thesia patients who were treated by elective abdominal hysterectomy surgery ,were selected in the hospital .The rela-tionship between the fentanyl consumption of intravenous analgesia and OPRMI and CYP 3A gene polymorphisms was detected by using polymerase chain reaction-restriction fragment length polymorphism detection .Results In 198 pa-tients,OPRM1 genotyping was 186 cases,the other 10 patients failed to typing were excluded ,including 89 cases of type A/A,type A/G 76 cases,type G/G 21 cases,OPRM1 the frequency of A118G allele was 31.7%.No statistically significant differences were found in mean VAS score of CYP 3A4＊1/＊1,CYP3A4＊1/＊1G,CYP3A4＊1G/＊1G instantly after operation in the three groups and 24h postoperation.By using analysis of variance with body mass ,age and intraoperative volume as a covariate factors after first 24h fentanyl consumption ,the difference was statistically sig-nificant among the three groups （P〈0.05）,CYP3A4＊1G/＊1G group was significantly lower than that in CYP3A4＊1/＊1G group and CYP3A4＊1/＊1 group,there was no significant difference between CYP 3A4＊1/＊1G group and CYP3A4＊1/＊1 group （P〉0.05）.In addition,because the OPRM1 A118G interacts with CYP3A4＊1G, reducedthe quantity of expression of opioid receptor carrying CYP 3A4＊1 and OPRM1 A118G/G,and thus more fent-anyl was needed postoperation to achieve the same effect .Conclusion It provided a theoretical basis and reference for clinical application of personalized medicine by analyzing the gynecological patients μopioid receptor gene A118G and CYP3A4＊1G polymorphism. Key words: OPRM1 ; CYP3A ; Genetic polymorphism ; Fentanyl ; Analgesic effect