| Objective To investigate the effect of CYP3A4 genetic polymorphism on sufentanil for postoperative analgesia after cesarean section in Chinese Han population.Methods 60 ASA I or II patients aged 22-40 yr undergoing elective cesarean section, with gestational age 38-40, height 155cm-175 cm and weight 60-85 kg,and no other complications were divided into 3 groups: homozygous mutation group, heterozygous mutation group and wild type group. All patients were under spinal and epidural anesthesia,having routine preoperative fasting and without any premedication( 0.75% ropivacaine 1.5ml were using in spinal anesthesia combined with cerebrospinal fluid dispensed into isobaric solution). Every groud received patient-controlled epidural analgesia(PCEA), PC EA( sufentanil 2.5μg/kg and saline 150 ml in total) include load ing 0.1μg/kg, background 2ml/h and bolus of 2ml with a 15 min lockout time. Recorded the dosage of sufentanil in the 48 h, the times of the PCA and the visual analog scale(VAS) in 48 h under sedation. Sedation analog scales and side effects were also recorded. By using double blind method, to campare the analgesic effect, the dosage of sufentanil and the PCA times in each group with the same drugs.Results The dosage of sufentanil and the PCA times in three groups are obviously different. It is less in the homozygous mutation group than other two groups(P<0.05).There is no significan difference in heterozygous mutation group and wild type group(P>0.05). The analgesic effect has no difference in three groups.Conclusion In postoperative analgesia after cesarean section using the same dose sufentanil, the sufentanil dosage is less in women with the genotype of homozygous mutation than in heterozygous mutation and wild type group genotype. There is also no obvious difference in sedation and side effects. It is suggested that CYP3A4 genetic polymorphism can direct the personalized medicine in sufentanil analgesia. |
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