Effect Of COMT Gene Haplotype On Postoperative Fentanyl Requirements In Patients

Objective:The aim of this study was to investigate the effect of COMT gene haplotype on postoperative fentanyl analgesia in patients undergoing radical gastrectomy.Methods:115patients of ASA â… -â…¢, who were scheduled to undergo radical gastrectomy under general anesthesia were enrolled in this study. Patients received postoperative PCIA until48h after surgery. It maintained VAS score<30mm. The fentanyl consumption and side effects were recorded in the first24h and48h postoperatively. Rs6269was screened by DNA sequence analysis of polymerase chain reaction (PCR)-amplified DNA. Rs4633, rs4818and rs4680were genotyped by PCR-RFLP. The difference in fentanyl consumption was compared among their genotypes and haplotypes at24and48h following surgery.Results:There was no significant difference in fentanyl dose among the genetic polymorphisms of rs6269, rs4633, rs4818and rs4680at24and48h after surgery (P>0.05). In the first48h following surgery, COMT gene haplotype "GCGG" which was constructed by rs6269, rs4633, rs4818and rs4680consumed significantly less fentanyl compared with other haplotypes (P<0.05). COMT gene haplotype "ACCG" had higher fentanyl comsumptions in the first24h and48h postoperatively (P<0.05). No correlation between rs6269, rs4633, rs4818, rs4680and postoperative nausea, vomiting and dizziness was found (P>0.05).Conclusions:COMT gene haplotype which is constructed by rs6269, rs4633, rs4818and rs4680is the factor contributing to the individual variation in postoperative analgesia with fentanyl.9Figures,6Tables,30References.