Korean J Pain.  2016 Jan;29(1):34-39. 10.3344/kjp.2016.29.1.34.

The Influence of Genotype Polymorphism on Morphine Analgesic Effect for Postoperative Pain in Children

• Lee MG
• Kim HJ
• Lee KH
• Choi YS

• KMID: 2151658
• DOI: http://doi.org/10.3344/kjp.2016.29.1.34

Abstract

BACKGROUND
Although opioids are the most commonly used medications to control postoperative pain in children, the analgesic effects could have a large inter-individual variability according to genotypes. The aim of this study was to investigate the association between single nucleotide polymorphisms and the analgesic effect of morphine for postoperative pain in children.
METHODS
A prospective study was conducted in 88 healthy children undergoing tonsillectomy, who received morphine during the operation. The postoperative pain score, frequency of rescue analgesics, and side effects of morphine were assessed in the post-anesthesia care unit. The children were genotyped for OPRM1 A118G, ABCB1 C3435T, and COMT Val158Met.
RESULTS
Children with at least one G allele for OPRM1 (AG/GG) had higher postoperative pain scores compared with those with the AA genotype at the time of discharge from the post-anesthesia care unit (P = 0.025). Other recovery profiles were not significantly different between the two groups. There was no significant relationship between genotypes and postoperative pain scores in analysis of ABCB1 and COMT polymorphisms.
CONCLUSIONS
Genetic polymorphism at OPRM1 A118G, but not at ABCB1 C3435T and COMT Val158Met, influences the analgesic effect of morphine for immediate acute postoperative pain in children.

Keyword

ABCB1 protein, human; Child; COMT protein, human; Morphine; OPRM protein, human; Pain; Postoperative

MeSH Terms

Alleles
Analgesics
Analgesics, Opioid
Child*
Genotype*
Humans
Morphine*
Pain, Postoperative*
Polymorphism, Genetic
Polymorphism, Single Nucleotide
Prospective Studies
Tonsillectomy
Analgesics
Analgesics, Opioid
Morphine

Figure

• 

  Fig. 1 Median postoperative pain scores in OPRM1 AA and AG/GG genotypes. (A) Pain score upon arrival in the PACU, (B) Pain score 15 min after PACU arrival, and (C) Pain score upon discharge from the PACU. *P < 0.05 compared with AA genotype. PACU: post-anesthesia care unit.

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