The influence of cytochrome p-450 gene polymorphisms on the tramadol postoperative analgesia effectiveness


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Abstract

The effectiveness of postoperative analgesia may be determined by genetic characteristics of patients that affect the pharmacodynamics and pharmacokinetics of drugs. In particular, as a result of the metabolism of tramadol by isoenzyme of cytochrome P-450 is formed O-desmethyltramadol having higher affinity to mu-opioid receptors. The paper explored the effectiveness of analgesia based on tramadol in 48 patients after endoscopic gynecological surgery depending on the presence/absence of polymorphisms of CYP2D6 gene.It was found that 15 patients with polymorphisms С100Т and G1846A had more intensive postoperative pain, which was accompanied by activation of the sympathetic nervous system. Determination of these polymorphisms may be useful to select the optimal postoperative analgesia.

About the authors

D. A Sokolov

Federal state budgetary educational institution of higher education “Yaroslavl state medical university” of the Russian Federation ministry of healthcare

150000, Ярославль

Pavel A. Lyuboshevskiy

Federal state budgetary educational institution of higher education “Yaroslavl state medical university” of the Russian Federation ministry of healthcare; State budgetary healthcare institution of the Yaroslavl region “Regional perinatal center”

Email: pal_ysma@mail.ru
MD, PhD, DSc, Head of the department of anesthesiology and resuscitation, Yaroslavl State Medical Universuty 150000, Ярославль

N. Yu Levshin

Federal state budgetary educational institution of higher education “Yaroslavl state medical university” of the Russian Federation ministry of healthcare

150000, Ярославль

A. V Zhemchugov

Federal state budgetary educational institution of higher education “Yaroslavl state medical university” of the Russian Federation ministry of healthcare; State budgetary healthcare institution of the Yaroslavl region “Regional perinatal center”

150000, Ярославль

L. V Kuptsova

State budgetary healthcare institution of the Yaroslavl region “Regional perinatal center”

150042, Ярославль

References

  1. Gerbershagen H.J., Aduckathil S., vanWijck A.J.M. et al. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013; 118(4): 934-44.
  2. Allvin R., Rawal N., Johanzon E., Bäckström R. Open versus laparoscopic surgery: does the surgical technique influence pain outcome? Results from an international registry.Pain res.treat. 2016; 2016: 4087325. Published online 2016 March 22. doi: 10.1155/2016/4087325
  3. Nielsen C.S., Staud R., Price D.D. Individual differences in pain sensitivity: measurement, causation, and consequences. J Pain. 2009; 10: 231-37.
  4. Потапов А.Л., Бояркина А.В. Полиморфизм генов мю1-опиоидного рецептора и катехол-о-метилтрансферазы влияет на предоперационное психологическое состояние пациентов и эффективность послеоперационной анальгезии наркотическими анальгетиками. Анестезиология и реаниматология. 2015; 3: 48-51.
  5. Женило В.М., Махарин О.А. Влияние полиморфизма гена OPRM1 118A/G на перцепцию боли и фармакодинамику наркотических анальгетиков. Общая реаниматология. 2014; 1: 66-75.
  6. Сычев Д.А., Муслимова О.В., Гаврисюк Е.В. и др. Фармакогенетические технологии персонализированной медицины: оптимизация применения лекарственных средств. Terra Medica. 2011; 1: 4-9.
  7. Хохлов А.Л., Лилеева А.Г., Рыбачкова Ю.В. и др. Значение определения полиморфизмов генов, отвечающих за активность ангиотензинпревращающего фермента у больных с артериальной гипертензией и хронической сердечной недостаточностью для оптимизации стандартов лечения больных артериальной гипертензией. Проблемы стандартизации в здравоохранении. 2012; 4: 41-4.
  8. Leppert W. CYP2D6 in the metabolism of opioids for mild to moderate pain. Pharmacology. 2011; 87: 274-85.
  9. McGraw J., Waller D. Cytochrome P450 variations in different ethnic populations. Expert Opin Drug Metab Toxicol. 2012; 8(3): 371-82.
  10. Yiannakopoulou E. Pharmacogenomics and Opioid Analgesics: Clinical Implications. Int J Genomics. 2015; 2015: 368979. doi: 10.1155/2015/368979
  11. Овечкин А.М. Послеоперационная боль: состояние проблемы и современные тенденции послеоперационного обезболивания. Регионарная анестезия и лечение острой боли. 2015; 9(2): 29-39.

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