Effect Of CYP3A4 Gene SNPrs2242480 On Postoperative Analgesia Of Sufentanil In Zhuang Women In Western Guangxi

Objective:(1)to investigate the distribution of CYP3A4 gene snprs2242480 in Zhuang and Han women in Western Guangxi and its dose effect relationship with sufentanil for postoperative analgesia.(2)To provide a theoretical basis for the realization of sufentanil individualized analgesia.Methods: From October 2019 to January 2021,150 patients with laparoscopic total hysterectomy(LTH)under general anesthesia in the Affiliated Hospital of Youjiang Medical University for Nationalities,aged 40-65,were divided into two groups,75 cases in Han group and 75 cases in Zhuang group.Patient controlled intravenous analgesia(PCIA)was used postoperatively.All patients were approved by the ethics committee of the Affiliated Hospital of Youjiang Medical College for nationalities.The genotypes of CYP3A4 snprs2242480 were detected by polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP).According to the genotypes,the Zhuang group and the Han group were divided into three groups.The Zhuang group was divided into wild-type homozygous C / C group,mutant heterozygous C / T group and mutant homozygous T / T group;the Han group was divided into wild-type homozygous C / C group and mutant homozygous T / T group Heterozygous C / T group and mutant homozygous T / T group.The pain score,Ramsay Sedation score,heart rate,mean arterial pressure,dosage of sufentanil and adverse reactions were observed and recorded at 6 h(T1),24 h(T2)and 48 h(T3)after operation.The collected data were processed and analyzed by spss22.0 software.The differences of snprs2242480 mutation rate of CYP3A4 gene and the average consumption of sufentanil of three genotypes between Zhuang and Han patients were compared.Objective to study the relationship between CYP3A4 snprs2242480 and sufentanil analgesia.Results:(1)According to the mutation of CYP3A4 SNPrs2242480,the patients were divided into C/C type,C/T type and T/T type,among which 55 cases of C/C type 13 cases of C/T type,5 T/Ttype patients in Zhuang group,15.8% of CYP3A4 SNPrs2242480,and38 cases of C/C type,25 cases of C/T ype,9 cases of T/T type in Han group,and 29.9% of CYP3A4 SNPrs2242480.(2)The average consumption of sufentanil in the Zhuang group was(116.08±7.85)ug at 48 h after operation,and that of sufentanil in Han group was(112.85±7.27)ug.The difference between the two groups was statistically significant(P < 0.05).The consumption of sufentanil(118.56±6.70ug)ug in the wild type(C/C)group was significantly higher than that of the mutation heterozygote(C/T)group(111.20±2.53 ug,P < 0.05)and mutation homozygote(T/T)group(98.40±2.19 ug,P < 0.05).The consumption of sufentanil(116.96 ± 5.72ug)in the Han group was significantly higher than that of the mutation heterozygote(111.26 ± 4.28 ug,P < 0.05)and mutation homozygote(T/T)group(98.22 ±2.91 ug,P < 0.05).(3)There was no significant difference in VAS score,Ramsay score,heart rate and mean arterial pressure between the two groups(P > 0.05).Conclusion :(1)The mutation rate of CYP3A4 SNPrs2242480 was significantly different between Zhuang and Han populations in Youjiang Medical University for Nationalities.The mutation rate of CYP3A4 SNPrs2242480 was 15.8% in Zhuang patients and 29.9% in Han patients.The mutation rate of CYP3A4 SNPrs2242480 in Zhuang patients was significantly lower than that in Han patients.(2)The consumption of sufentanil in Zhuang group was significantly higher than that in Han group,which may be related to the fact that CYP3A4 SNPrs2242480 can reduce the metabolism of sufentanil and prolong the analgesia time.