The Genetics of Pain: Implications for Perioperative Pain Management

Abstract

Aim of review: Postoperative pain is one of the most common symptoms in surgical patients. Although numerous measures, such as patient-controlled analgesia and multimodal analgesia, have been developed, postoperative pain treatment is not yet adequate. Human genome analysis allows us to investigate interindividual differences in pain thresholds and pain perception at the genetic level. This article aimed to review important and illustrative results from recent pain genetic studies in this field and to interpret their clinical implications for perioperative pain management.Method: Literatures were searched via PubMed with the key words of genetics of pain, perioperative pain, cytochrome P450 (CYP450), mu-opioid receptor (MOR)-1, catecholamine-O-methyltransferase (COMT), guanosine triphosphate (GTP) cyclohydrolase 1 (GCH1), interleukin (IL)-1B, SCN9A, CACNG2, transient receptor potential vanilloid-1 (TRPV1) and TRP ankyrin-1 (TRPA1). A few review articles in the relevant fields were also referenced.Recent findings: There is a growing body of compelling evidence indicating that interindividual differences in pain sensitivity and the predisposition to chronic pain are genetically determined. During the past decade, numerous pain-related genes and their functional polymorphisms have been identified, including CYP450, MOR-1, COMT, GCH1, etc. These functional gene polymorphisms are valuable to perioperative pain management.Summary: The identification of genetic markers relevant to perioperative pain management may help to predict pain susceptibility, severity, and treatment response in surgical patients. As the foundation for interindividual variability in the experience of postoperative pain, genetic variability will aid anesthesiologists to develop the personalized perioperative pain management strategy. Citation: Meng-Meng Bao, Fang Xie, Xue-Yang Li, Yun Yue, Yun Guan, Yun Wang. The genetics of pain: implications for perioperative pain management. J Anesth Perioper Med 2015; 2: 205-15. doi: 10.24015/JAPM.2015.0028This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.