Effects of µ-Opioid Receptor Gene Polymorphism on Postoperative Nausea and Vomiting in Patients Undergoing General Anesthesia with Remifentanil: Double Blinded Randomized Trial.
Association between postoperative nausea and vomiting (PONV) and µ-opioid receptor A118G single nucleotide polymorphism (SNP) is undefined and might underlie inconsistent results of studies on PONV occurrence in patients undergoing general anesthesia with the opioid, remifentanil. Four hundred and sixteen Korean women undergoing breast surgery with general anesthesia were randomized to receive remifentanil 10 ng/mL (plasma-site, Minto model) using a target-controlled infusion device and either propofol for total intravenous anesthesia (T group) or sevoflurane for inhalation anesthesia (I group) with bispectral index values maintained between 40 and 60. Blood specimens were collected after anesthesia induction for A118G SNP analysis. PONV and postoperative pain were evaluated. A118G SNP type distribution among Korean female adults studied was AG (n=195)>AA (n=158)>GG (n=63). Regardless of anesthetic technique, patients with GG types had lower PONV scale on arrival at postoperative care unit (PACU) (P=0.002), while T group showed lower PONV scale than I group up to 6 hr after PACU discharge in AA and AG types. No differences were apparent for postoperative pain among opioid receptor polymorphism. PONV occurrence differs according to opioid receptor polymorphism and anesthetic technique in patients undergoing general anesthesia with remifentanil.
Department of Microbiology, Konkuk University School of Medicine, Seoul, Korea.
Seung-Hyun
0000-0001-8023-1404
SH
Lee
Department of Microbiology, Konkuk University School of Medicine, Seoul, Korea.
Joo-Dong
0000-0001-8405-9699
JD
Kim
Department of Microbiology, Konkuk University School of Medicine, Seoul, Korea.
Sol-Ah
0000-0002-4046-354X
SA
Park
Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Chung-Sik
0000-0001-8874-5186
CS
Oh
Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. ; Institute of Biomedical Science and Technology, Konkuk University School of Medicine, Seoul, Korea.
Seong-Hyop
0000-0001-7764-9818
SH
Kim
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects*; D001941:Breast Diseases / Q000601:surgery; D003710:Demography; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008738:Methyl Ethers / Q000009:adverse effects / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy; D010880:Piperidines / Q000009:adverse effects* / Q000627:therapeutic use; D020641:Polymorphism, Single Nucleotide; D020250:Postoperative Nausea and Vomiting / Q000209:etiology*; D017450:Receptors, Opioid, mu / Q000235:genetics*; D000077208:Remifentanil; D000077149:Sevoflurane
D000701:Analgesics, Opioid; D008738:Methyl Ethers; D010880:Piperidines; D017450:Receptors, Opioid, mu; D000077149:Sevoflurane; D000077208:Remifentanil
Anesthetics, General; Polymorphism, Single Nucleotide; Postoperative Nausea and Vomiting; Receptors, Opioid, µ