title: Genotyping test with clinical factors: better management of acute postoperative pain?
abstract: Individualization of acute postoperative pain treatment on an evidence-based decision process is a major health concern. The aim of this study is to investigate the influence of genetic and non-genetic factors on the variability of response to morphine in acute postoperative pain. A group of nighty-five patients undergoing major surgery were included prospectively. At 24 h, a logistic regression model was carried out to determine the factors associated with morphine doses given by a Patient Controlled Analgesia device. The dose of morphine was associated with age (p = 0.011), patient weight (p = 0.025) and the duration of operation (p = 0.030). This dose decreased with patient's age and duration of operation and increased with patient's weight. OPRM1 and ABCB1 polymorphisms were significantly associated with administered dose of morphine (p = 0.038 and 0.012 respectively). Patients with at least one G allele for c.118A>G OPRM1 polymorphism (AG/GG) needed 4 times the dose of morphine of AA patients. Additionally, patients with ABCB1 CT and CC genotypes for c.3435C>T polymorphism were 5.6 to 7.1 times more prone to receive higher dose of morphine than TT patients. Our preliminary results support the evidence that OPRM1/ABCB1 genotypes along with age, weight and duration of operation have an impact on morphine consumption for acute postoperative pain treatment.
authors: Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculté de Pharmacie, Saint-Joseph University of Beirut, B.P. 11-5076-Riad El Solh, Beirut 1107 2180, Lebanon. aline.hajj1@usj.edu.lb.|Université Paris Descartes, Unité INSERM UMR-S 1144, Paris F-75006, France. aline.hajj1@usj.edu.lb.
authors: Aline
authors: A
authors: Hajj
authors: Université Paris Descartes, Unité INSERM UMR-S 1144, Paris F-75006, France. katell.peoch@bjn.aphp.fr.
authors: Katell
authors: K
authors: Peoc'h
authors: Université Paris Descartes, Unité INSERM UMR-S 1144, Paris F-75006, France. jean-louis.laplanche@inserm.fr.
authors: Jean-Louis
authors: JL
authors: Laplanche
authors: Department of Anesthesia and Critical Care, Hôtel-Dieu de France Hospital-Saint-Joseph University of Beirut, B.P. 16-6830, Beirut 1100 2160, Lebanon. hicham.jabbour@usj.edu.lb.
authors: Hicham
authors: H
authors: Jabbour
authors: Department of Anesthesia and Critical Care, Hôtel-Dieu de France Hospital-Saint-Joseph University of Beirut, B.P. 16-6830, Beirut 1100 2160, Lebanon. nicole.naccache@usj.edu.lb.
authors: Nicole
authors: N
authors: Naccache
authors: Department of Anesthesia and Critical Care, Hôtel-Dieu de France Hospital-Saint-Joseph University of Beirut, B.P. 16-6830, Beirut 1100 2160, Lebanon. hicham.abouzeid1@usj.edu.lb.
authors: Hicham
authors: H
authors: Abou Zeid
authors: Department of Anesthesia and Critical Care, Hôtel-Dieu de France Hospital-Saint-Joseph University of Beirut, B.P. 16-6830, Beirut 1100 2160, Lebanon. patricia.yazbeck@usj.edu.lb.
authors: Patricia
authors: P
authors: Yazbeck
authors: Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculté de Pharmacie, Saint-Joseph University of Beirut, B.P. 11-5076-Riad El Solh, Beirut 1107 2180, Lebanon. lydia.khabbaz@usj.edu.lb.
authors: Lydia Rabbaa
authors: LR
authors: Khabbaz
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000235:genetics; D000328:Adult; D000368:Aged; D000483:Alleles; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000235:genetics* / Q000517:prevention & control; D011110:Polymorphism, Genetic / Q000235:genetics; D017450:Receptors, Opioid, mu / Q000235:genetics
chemical_list: C513055:ABCB1 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; C485764:OPRM1 protein, human; D017450:Receptors, Opioid, mu; D009020:Morphine