Genetic polymorphisms result in absent enzyme activity of CYP2D6 (poor metabolizers, PM) in about 10% of the Caucasian population. This study investigates whether the PM genotype has an impact on the response to tramadol analgesia in postoperative patients. A prospective study design was used and 300 patients recovering from abdominal surgery were enrolled. After titration of an individual loading dose, patients could self-administer I nil bolus doses of the drug combination tramadol 20 mg/ml, dipyrone 200 mg/ml and metoclopramide 0.4 mg/ml via patient-controlled analgesia (PCA). Patients' genotype was analyzed considering the most prevalent PM associated CYP2D6 mutations using a real-time PCR and hybridization based genotyping method. Demographic data, surgery related variables, pain scores, analgesic consumption and need for rescue medication were compared between extensive metabolizers (EM) and PM. The primary outcome criterion 'response' was defined as responder or non-responder status by the need for rescue medication and patients' satisfaction at the final interview. Demographic and surgery related data were comparable between EM (n = 241) and PM (n = 30). The percentage of non-responders was significantly higher in the PM group (46.7%) compared with the EM group (21.6%; p = 0.005). Tramadol loading dose amounted to 108.2 +/- 56.9 and 144.7 +/- 22.6 mg (p < 0.001) in EM and PM, respectively, More patients displaying the PM genotype needed rescue medication in the recovery room and during PCA period than patients with at least one wild type allele (21.6 versus 43.3%, p = 0.02). PM for CYP2D6 showed a lower response rate to postoperative tramadol analgesia than EM. Therefore, CYP2D6 genotype has an impact on analgesia with tramadol. Pharmacogenetics may explain some of the varying response to pain medication in postoperative patients. (C) 2003 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
机构:The Second Affiliated Hospital of Harbin Medical University,Department of Anesthesiology, China and Heilongjiang Key Laboratory for Anesthesia and Critical Care
Hong Dong
Shu-jun Lu
论文数: 0引用数: 0
h-index: 0
机构:The Second Affiliated Hospital of Harbin Medical University,Department of Anesthesiology, China and Heilongjiang Key Laboratory for Anesthesia and Critical Care
Shu-jun Lu
Rui Zhang
论文数: 0引用数: 0
h-index: 0
机构:The Second Affiliated Hospital of Harbin Medical University,Department of Anesthesiology, China and Heilongjiang Key Laboratory for Anesthesia and Critical Care
Rui Zhang
Dong-dong Liu
论文数: 0引用数: 0
h-index: 0
机构:The Second Affiliated Hospital of Harbin Medical University,Department of Anesthesiology, China and Heilongjiang Key Laboratory for Anesthesia and Critical Care
Dong-dong Liu
Yan-zhuo Zhang
论文数: 0引用数: 0
h-index: 0
机构:The Second Affiliated Hospital of Harbin Medical University,Department of Anesthesiology, China and Heilongjiang Key Laboratory for Anesthesia and Critical Care
Yan-zhuo Zhang
Chun-yu Song
论文数: 0引用数: 0
h-index: 0
机构:The Second Affiliated Hospital of Harbin Medical University,Department of Anesthesiology, China and Heilongjiang Key Laboratory for Anesthesia and Critical Care
Chun-yu Song
European Journal of Clinical Pharmacology,
2015,
71
: 681
-
686
机构:
Univ Sains Malaysia, Sch Med Sci, Dept Pharmacol, Kubang 16150, Kelantan, MalaysiaUniv Sains Malaysia, Sch Med Sci, Dept Pharmacol, Kubang 16150, Kelantan, Malaysia
Gan, SH
Ismail, R
论文数: 0引用数: 0
h-index: 0
机构:Univ Sains Malaysia, Sch Med Sci, Dept Pharmacol, Kubang 16150, Kelantan, Malaysia
Ismail, R
Adnan, WAW
论文数: 0引用数: 0
h-index: 0
机构:Univ Sains Malaysia, Sch Med Sci, Dept Pharmacol, Kubang 16150, Kelantan, Malaysia
Adnan, WAW
Wan, Z
论文数: 0引用数: 0
h-index: 0
机构:Univ Sains Malaysia, Sch Med Sci, Dept Pharmacol, Kubang 16150, Kelantan, Malaysia
机构:
Hungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, HungaryHungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, Hungary
Kiss, Adam Ferenc
Toth, Katalin
论文数: 0引用数: 0
h-index: 0
机构:
Hungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, HungaryHungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, Hungary
Toth, Katalin
Juhasz, Cintia
论文数: 0引用数: 0
h-index: 0
机构:
Hungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, HungaryHungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, Hungary
Juhasz, Cintia
Temesvari, Manna
论文数: 0引用数: 0
h-index: 0
机构:
Hungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, HungaryHungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, Hungary
Temesvari, Manna
Paulik, Jozsef
论文数: 0引用数: 0
h-index: 0
机构:
Nucleotest Bio Ltd, Tunderliget 3-2, H-1038 Budapest, HungaryHungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, Hungary
Paulik, Jozsef
Hirka, Gabor
论文数: 0引用数: 0
h-index: 0
机构:
Toxi Coop Toxicol Res Ctr Co, Magyar Jakobinusok 4, H-1122 Budapest, HungaryHungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, Hungary
Hirka, Gabor
Monostory, Katalin
论文数: 0引用数: 0
h-index: 0
机构:
Hungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, HungaryHungarian Acad Sci, Res Ctr Nat Sci, Magyar Tudosok 2, H-1117 Budapest, Hungary