title: Role of CYP2D6 Polymorphisms in the Outcome of Postoperative Pain Treatment.
abstract: OBJECTIVE
  To investigate the role of CYP2D6 phenotype in the outcome of postoperative (PO) pain (POP) treatment.
  
  
  METHODS
  Longitudinal cohort study. Open-label trial with post hoc analysis.
  
  
  METHODS
  General Hospital Surgery and Recovery Units.
  
  
  METHODS
  Ninety unrelated Caucasians submitted to abdominal/thoracic surgery.
  
  
  METHODS
  Standard multimodal POP treatment including opioids (tramadol) and nonsteroidal anti-inflammatory drugs (ketoprofen) at different dosages and infusion rates according to the predicted mild, moderate, or severe POP.
  
  
  METHODS
  Pain (Numeric Rating Scale-NRS) and sedation (Ramsay Sedation Scale-RSS) up to 24 hours after surgery. By genotyping 16 CYP2D6 alleles, the four CYP2D6 phenotypes poor metabolizer (PM), intermediate metabolizers (IM), extensive metabolizers (EM) and ultrarapid metabolizers (UM) were predicted.
  
  
  RESULTS
  As compared with the CYP2D6-EM phenotype, in the early PO time (30 min) a higher RSS mean score in IM was observed (P = 0.035). A suggestion towards higher mean score in PM (P = 0.091) and a minor mean score in UM (P = 0.091) was also detected. No difference in the outcome of pain across the CYP2D6 phenotypes was observed.
  
  
  CONCLUSIONS
  In respect to the normal CYP2D6 phenotype, our results suggested that slowly metabolizers (IMs and PMs) might have a major sedation, whereas more rapid metabolizers (UM) a minor sedation, in the early time after surgery. A minor role of CYP2D6 phenotype in PO analgesia may be suggested.
authors.affiliation: Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Seripa
authors.affiliation: Recovery Unit 1, Emergency Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Latina
authors.affiliation: Biostatistics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fontana
authors.affiliation: Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Gravina
authors.affiliation: Medical Systems S.p.A., Genova, Italy.
authors.forename: Monia
authors.initials: M
authors.lastname: Lattanzi
authors.affiliation: Laboratory of Clinical Chemistry, Department of Clinical Pathology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Savino
authors.affiliation: Laboratory of Clinical Chemistry, Department of Clinical Pathology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Antonietta P
authors.initials: AP
authors.lastname: Gallo
authors.affiliation: Recovery Unit 1, Emergency Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Melchionda
authors.affiliation: Laboratory of Hormonal Analyses and Clinical Molecular Biology, Department of Diagnostics and Laboratory Medicine, Catholic University School of Medicine, Rome, Italy.
authors.forename: Stefano A
authors.initials: SA
authors.lastname: Santini
authors.affiliation: Chair of Medical Genetics, Department of Biomedical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Margaglione
authors.affiliation: Biostatistics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Copetti
authors.affiliation: Laboratory of Clinical Chemistry, Department of Clinical Pathology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Lazzaro
authors.initials: L
authors.lastname: di Mauro
authors.affiliation: Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.|Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.|Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico,", Lecce, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Panza
authors.affiliation: Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Greco
authors.affiliation: Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.|Geriatrics Unit, Azienda ULSS16 Padova, S. Antonio Hospital, Padova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pilotto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics*; D005260:Female; D005819:Genetic Markers / Q000235:genetics; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics; D005819:Genetic Markers; D019389:Cytochrome P-450 CYP2D6
keywords: CYP2D6; Cytochrome P450; Ketoprofen; POP; Pharmacogenetics; Postoperative Pain Treatment; Tramadol