title: Postoperative nausea and vomiting: The role of the dopamine D2 receptor TaqIA polymorphism.
abstract: BACKGROUND
  The risk of developing postoperative nausea and vomiting (PONV), apart from conventional risk factors, probably includes a genetic background.
  
  
  OBJECTIVE
  We examined the association of the DRD2 TaqIA polymorphism with PONV in a high-risk cohort of patients.
  
  
  METHODS
  A prospective, double-blind observational trial.
  
  
  METHODS
  Single-centre primary care in Western Germany.
  
  
  METHODS
  A total of 306 patients undergoing elective strabismus surgery under anaesthesia with etomidate/alfentanil/mivacurium (induction) and sevoflurane in air (maintenance).
  
  
  METHODS
  Nausea as well as retching/vomiting was recorded for 24 h postoperatively. The DRD2 TaqIA polymorphism (rs1800497) was genotyped using a Taqman assay and the relationship between DRD2 TaqIA polymorphism and PONV was examined by univariate and multivariate analysis.
  
  
  RESULTS
  Regarding known risk factors for developing PONV, no patient with the A1A1 genotype (n = 15) had a history of PONV, while A1A2 carriers (n = 115) and A2A2 carriers (n = 176) had a history of PONV in 22.6 and 10.8% of patients, respectively (P = 0.005). Overall, the incidence of nausea was 40.1% and the incidence of vomiting/retching was 32.7%. Univariate analysis showed that postoperative nausea was not associated with TaqIA genotypes, but the incidence of retching/vomiting in A1A2 and A2A2 genotypes was more than 34% compared with zero in A1A1 genotypes (P = 0.022). Age, sex, smoking status and a history of PONV were independent predictors for nausea as well as for retching/vomiting, as expected, while DRD2 TaqIA polymorphism showed no independent significant impact.
  
  
  CONCLUSIONS
  In a white cohort, the TaqIA A2 allele is significantly associated with a history of PONV, which may explain the increased incidence of PONV but has no further independent influence.
  
  
  BACKGROUND
  German registry of clinical trials identifier: DRKS00005681.
authors.affiliation: From the Klinik für Anästhesiologie und Intensivmedizin (UHF, CS, MA, M-TS, JP), and Zentrum für Augenheilkunde, Klinik für Erkrankungen des vorderen Augenabschnitts, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany (JE).
authors.forename: Ulrich H
authors.initials: UH
authors.lastname: Frey
authors.forename: Christoph
authors.initials: C
authors.lastname: Schnee
authors.forename: Marc
authors.initials: M
authors.lastname: Achilles
authors.forename: Marie-Therese
authors.initials: MT
authors.lastname: Silvanus
authors.forename: Joachim
authors.initials: J
authors.lastname: Esser
authors.forename: Jürgen
authors.initials: J
authors.lastname: Peters
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D005787:Gene Frequency; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D010641:Phenotype; D011110:Polymorphism, Genetic; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000175:diagnosis / Q000208:ethnology / Q000235:genetics*; D011446:Prospective Studies; D017448:Receptors, Dopamine D2 / Q000235:genetics*; D012307:Risk Factors; D013285:Strabismus / Q000175:diagnosis / Q000208:ethnology / Q000601:surgery*; D044465:White People / Q000235:genetics; D055815:Young Adult
chemical_list: C581293:DRD2 protein, human; D017448:Receptors, Dopamine D2