title: Common variants of catechol-O-methyltransferase influence patient-controlled analgesia usage and postoperative pain in patients undergoing total hysterectomy.
abstract: Catechol-O-methyltransferase (COMT) gene polymorphisms and haplotypes have been associated with both experimental and clinical pain phenotypes. In this prospective study, we investigated the association of three common polymorphisms with experimentally induced pressure pain, postoperative pain and amount of self-administered morphine in 973 patients who underwent scheduled total hysterectomy. DNA extracted from peripheral blood was genotyped for three COMT polymorphisms by Taqman assay or a PCR-based method. In the overall sample, rs4633 and rs4680 were significantly associated with morphine use, whereas rs4818 was associated with time-averaged pain scores. Statistically significant associations were found between COMT rs4633 and rs4680 genotypes and the amount of morphine self-administered through a patient-controlled analgesia pump. For rs4818, the only statistically significant association was with time-averaged pain scores. Haplotype analysis showed statistically significant association of the low pain sensitivity haplotype with time-averaged pain scores; and average pain sensitivity haplotype with total morphine and weight-adjusted morphine.
authors.affiliation: KK Research Centre, KK Women's and Children's Hospital, Singapore.|Duke-NUS Graduate Medical School, Singapore.
authors.forename: E-C
authors.initials: EC
authors.lastname: Tan
authors.affiliation: KK Research Centre, KK Women's and Children's Hospital, Singapore.
authors.forename: E C P
authors.initials: EC
authors.lastname: Lim
authors.affiliation: Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore.
authors.forename: C E
authors.initials: CE
authors.lastname: Ocampo
authors.affiliation: Duke-NUS Graduate Medical School, Singapore.
authors.forename: J C
authors.initials: JC
authors.lastname: Allen
authors.affiliation: Duke-NUS Graduate Medical School, Singapore.|Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore.
authors.forename: B-L
authors.initials: BL
authors.lastname: Sng
authors.affiliation: Duke-NUS Graduate Medical School, Singapore.|Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore.
authors.forename: A T
authors.initials: AT
authors.lastname: Sia
mesh_terms: D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D044466:Asian People; D002394:Catechol O-Methyltransferase / Q000235:genetics*; D005006:Ethnicity; D005260:Female; D005819:Genetic Markers; D005838:Genotype; D006239:Haplotypes; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008297:Male; D009020:Morphine / Q000008:administration & dosage*; D064887:Observational Studies as Topic; D010149:Postoperative Pain / Q000188:drug therapy* / Q000208:ethnology / Q000235:genetics; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D005819:Genetic Markers; D009020:Morphine; D002394:Catechol O-Methyltransferase