Effect Of OPRM1 Gene Polymorphism On Sufentanil Consumption After Cervical Cancer Surgery

Objective: To analyze the genotype of OPRM1 opioid receptor and to explorethe influence of gene polymorphism on the individualized difference of sufentanil postoperative supression pain in patients with cervical cancer,and to provide guidance for the individualized administration of postoperative analgesia reference.Methods: From August 2015 to August 2017,180 female patients undergoing elective wide-band gastrectomy combined with pelvic lymphadenectomy undergoing elective general anesthesia were selected as the study subjects.The study has been conducted by our hospital ethics committee Accepted and approved,and signed informed consent.The purpose of this dissertation research is to explore the use of two-dimensional chromatographic and mass spectrometry,q-PCR test methods in patients with tumor sufentanil analgesic effect,dosage and other aspects of OPRM1 subtypes to explore whether or not to give patients Intraperitoneal injection of 0.6 mg acetaminophen injection half an hour before surgery,open the peripheral venous access,500 ml sodium lactate Ringer solution intravenous infusion.Patients were given 0.1 ug / kg / h of sufentanil citrate,5-8 mg / kg / h of propofol,and 0.15 mg / kg/ h of besylate cisatracurium for continuous IV infusion.In the course of surgery,propofol and sufentanyl need to be adjusted for injection speed,which in turn controls the depth of anesthesia.Postoperatively,all patients required intravenous sufentanil for controlled analgesia.Patient pain was evaluated using the numerical rating scale(NRS)and the sufentanil consumption was recorded at postoperative wake-up time,12 hours,24 hours and 48 hours,and the patient was sedated Reaction and adverse reactions were recorded.Results: The genotypes of OPRM1A118 G were divided into wild-type homozygotes,mutant heterozygotes and mutant homozygotes(A / A,A / G,G / G)There was no significant difference in test(P >0.05).By genotyping OPRM1A118 G allele frequency in 180 patients with cervical cancer and successfully typing,the frequency of OPRM1A118 G allele was 40.28%.Among the wild-type homozygotes,heterozygotes and mutant-type alleles of OPRM1A118 G allele The distribution of zygotes was statistically tested,P<0.05,the difference was statistically significant,and in line with the Hardy-Weinbergequilibrium,indicating that the study selected the study of the OPRM1A118 G genotype distribution has reached a genetic balance.There was no significant difference in the plasma concentration of OPRM1A118 G between the three groups(P>0.05).According to the OPRM1A118 G genotype,there were no significant differences in the NRS pain scores between the wild homozygotes,the mutant heterozygotes and the mutant homozygotes immediately after surgery,12 h,24h and 48 h after surgery.0.05,affirmed the effect of sufentanil on postoperative analgesia.However,the results of the study showed that covariance analysis was performed according to age,body weight,height,BMI and sufentanil dosage.Compared with wild homozygotes and mutant heterozygotes,mutant homozygotes were 12 h,24h,48 h after surgery.The dosage of sufentanil was significantly increased,P <0.05,the difference was statistically significant.This indicates that there is a certain relationship between the analgesic effect of sufentanil and the OPRM1A118 G genotype.However,immediately after waking up,there was no significant difference in the consumption of sufentanil in the three groups,P>0.05,and the difference was statistically significant.The comparison between the mutant homozygotes and the mutant heterozygotes showed that there was no significant difference in the consumption of sufentanil in the two groups,P>0.05,and the difference was statistically significant.There was no significant difference in the postoperative NRS score and sedation response between the groups,P >0.05.The incidence of adverse reactions such as nausea,itching and vomiting in 180 patients was 14.44%(26/180).Among them,there were 12 cases of postoperative nausea,9cases of vomiting,and 5 cases of itching.The incidence of total adverse reactions was5.00% in the wild-type homozygous group,7.78% in the mutant heterozygous group,and 1.67% in the mutant homozygous group.No other adverse reactions were observed.Conclusion: The mutation frequency of OPRM1A118 G in Chinese patients with cervical cancer is 40.28%.The polymorphism of OPRM1A118 G has little effect on sufentanil plasma concentration,and has no obvious effect on sufentanil postoperative sedation response rate.However,there was a significant effect on the NRS score and the sufentanil consumption at 12 h,24h and 48 h after surgery.For patients with the mutation homozygous gene polymorphism,the dosage of sufentanilshould be increased to improve the individualized treatment effect.