Abstract
The aim: To assess the effect of COMT G1947A genetic polymorphism (val158met) on the efficacy of spinal analgesia on day 1 after laparoscopic surgery for colorectal cancer.Material and methods. In a pilot study involving 100 patients with colorectal cancer, operated through laparoscopic access, using spinal analgesia (10.0–12.5 mg of bupivacaine + 200 mcg of morphine), the frequency of COMT gene G1947A (val158met) polymorphism, the intensity of pain on day 1 after surgery, the frequency and severity of nausea, vomiting, skin itching, the need for additional analgesia have been assessed.Results. The frequency distribution of alleles val/val (25%), val/met (45%) and met/met (30%) was consisted with Hardy-Weinberg equilibrium (χ2=0.96; P>0.05) and was not significantly different from the healthy donor group. In the groups of patients with various COMT alleles of val158met polymorphism, the studied parameters also did not differ significantly.Conclusion. Study did not find significant link between spinal analgesia efficacy on day 1 after laparoscopic surgery for colorectal cancer and COMT rs4680 G1947A (val158met) polymorphism. Further research to enhance the power of the study is warranted to reach the final conclusions.
Highlights
The efficacy of perioperative analgesia may significantly vary between individuals, which can be due to the type of surgery and used analgesia, and to genetic causes
There is no data on the impact of this polymorphism on the efficacy of regional analgesia in the available literature
All patients signed an informed consent for participation and collection of genetic material
Summary
The efficacy of perioperative analgesia may significantly vary between individuals, which can be due to the type of surgery and used analgesia, and to genetic causes. One of the COMT functions is the metabolism of catecholamines in CNS synapses; it is reasonable to suggest that the change in its activity may affect the transmission and modulation of nociceptive signals, mediated by noradrenaline, dopamine, and serotonine [4]. COMT val158met polymorphism has been studied mainly in connection with systemic analgesia with narcotic analgesics [5,6,7,8,9]. Regional analgesia is a fundamental way to control pain in some types of surgical operations, for example, in colon surgery [10]. Testing the hypothesis of the effect of the COMT G1947A (val158met) polymorphism on the quality of regional analgesia will confirm or disprove the need for further research in this area
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