COMT Gene Haplotypes Are Closely Associated with Postoperative Fentanyl Dose in Patients. (April 2015)

• Record Type: Journal Article
• Authors: Zhang, Fan; Tong, Jianbin; Hu, Jie; Zhang, Hao; Ouyang, Wen; Huang, Dong; Tang, Qiuping; Liao, Qin
• Is Part Of: Anesthesia & analgesia. Volume 120:Number 4(2015)
• Publication Date: 2015-04
• Subjects: Anesthesiology -- Periodicals; Anesthesia; Anesthesiology; Analgesia; Analgesics; Anesthesiology -- Periodicals; 617.9605
• DOI: 10.1213/ANE.0000000000000563
• Languages: English
• ISSNs: 0003-2999

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>BACKGROUND:</title> <p>Fentanyl's analgesic efficacy varies widely among individuals. The single-nucleotide polymorphisms (SNPs) of catechol-<italic>O</italic>-methyltransferase (<italic>COMT</italic>) modulate sensitivity to pain. It remains unclear, however, whether <italic>COMT</italic> genetic variability affects postoperative fentanyl analgesia in patients undergoing radical gastrectomy.</p> </sec> <sec> <title>METHODS:</title> <p>One hundred fifteen patients, ASA physical status I–III, who were scheduled for radical gastrectomy under general anesthesia, were enrolled in this study. Patient-controlled IV analgesia with fentanyl was administered during the first 48 hours after surgery. Visual analog scale score for patients' pain was maintained at ⩽30 mm. The amount of fentanyl consumed and side effects were recorded for the first 24 and 48 hours postoperatively. The SNPs of <italic>COMT</italic> (rs6269, rs4633, rs4818, and rs4680) of all patients were screened by DNA sequence analysis of polymerase chain reaction−amplified DNA or polymerase chain reaction-restriction fragment length polymorphism.</p> </sec> <sec> <title>RESULTS:</title> <p>There were no significant differences in the doses of fentanyl used among patients possessing different SNPs of <italic>COMT</italic> rs6269, rs4633, rs4818, and rs4680 at 24 (all <italic>P</italic> > 0.207) and 48 (all <italic>P</italic> > 0.148) hours after surgery. <italic>COMT</italic> gene haplotypes combined by <italic>COMT</italic> rs6269, rs4633, rs4818, and rs4680, however, significantly affected fentanyl consumption at 24 (<italic>P</italic> = 0.029) and 48 (<italic>P</italic> = 0.032) hours after surgery. Among the haplotypes of <italic>COMT</italic> gene, patients with haplotype ACCG consumed more fentanyl than GCGG and ATCA haplotypes during the first 24 and 48 hours (all <italic>P</italic> < 0.042) after surgery. No significant differences were found in the incidence of nausea, vomiting, and dizziness among the 4 SNPs of <italic>COMT</italic> gene (all <italic>P</italic> > 0.079) and their haplotypes (all <italic>P</italic> > 0.482).</p> </sec> <sec> <title>CONCLUSIONS:</title> <p> <italic>COMT</italic> gene haplotype constructed by rs6269, rs4633, rs4818, and rs4680 contributes to the individual variation of postoperative analgesia with fentanyl. Patients carrying the <italic>COMT</italic> gene haplotype ACCG consumed the most drug during the first 24 and 48 hours postoperatively.</p> </sec> </abstract>