title: Effect of CYP3A4*18B polymorphisms and interactions with OPRM1 A118G             on postoperative fentanyl requirements in patients undergoing radical gastrectomy.
abstract: The present study aimed to investigate the effect of cytochrome P450 3A4             (CYP3A4)*18B polymorphisms and the interaction of the µ opioid receptor gene (OPRM1)             A118G and CYP3A4*18B polymorphisms on postoperative fentanyl analgesia in Chinese             Han patients undergoing radical gastrectomy. In total, 97 patients scheduled to             undergo radical gastrectomy under general anesthesia were enrolled in this study.             Post‑operative patient‑controlled intravenous analgesia of fentanyl was administered             as analgesia up to 48 h following surgery. Venous blood (2 ml) was obtained from             each patient to measure the OPRM1 A118G and CYP3A4*18B genotypes. The differences             in fentanyl consumption and adverse effects were compared among the genotypes             at 24 and 48 h following surgery. In the first 48 h following surgery, patients             in the CYP3A4*18B/*18B group consumed significantly less fentanyl compared with             patients in the *1/*1 group (P=0.032). With regards to the joint genetic effect,             during the 48‑h period, patients with AA and *1*18B polymorphisms received fewer             fentanyl doses compared with those with AG and *1*1 (P=0.049), while patients             with AG and *1*18B polymorphisms received significantly fewer fentanyl doses compared             with those with AG and *1*1 (P=0.010), and patients with *18B*18B polymorphisms             received significantly fewer fentanyl doses compared with those with AA and *1*1             (P=0.024) or those with AG and *1*1 polymorphisms (P=0.006). No correlation between             OPRM1 A118G and CYP3A4*18B and postoperative nausea, vomiting and dizziness was             found. Results demonstrated that 48 h following surgery, patients with the CYP3A4*18B/*18B             genotype required less fentanyl than patients with the CYP3A4*1/*1 genotype to             control pain. Additionally, the combined genotype of CYP3A4*18B and OPRM1 A118G             may affect fentanyl doses administered for pain control, but not postoperative             nausea, vomiting and dizziness.
authors: Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha 410013, PR China.
authors: Qin
authors: Q
authors: Liao
authors: Dao-Jin
authors: DJ
authors: Chen
authors: Fan
authors: F
authors: Zhang
authors: Li
authors: L
authors: Li
authors: Rong
authors: R
authors: Hu
authors: Yong-Zhong
authors: YZ
authors: Tang
authors: Wen
authors: W
authors: Ou-Yang
authors: Dong
authors: D
authors: Huang
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D051544:Cytochrome P-450 CYP3A / Q000235:genetics*; D004244:Dizziness / Q000209:etiology; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D005743:Gastrectomy; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D020641:Polymorphism, Single Nucleotide; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011184:Postoperative Period; D017450:Receptors, Opioid, mu / Q000235:genetics*; D013997:Time Factors; D014839:Vomiting / Q000209:etiology
chemical_list: D000701:Analgesics, Opioid; C485764:OPRM1 protein, human; D017450:Receptors, Opioid, mu; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human; D005283:Fentanyl