OBJECTIVES: The mechanism whereby acute postsurgical pain can persist and become chronic remains unknown. Thoracotomy is a common procedure with a high incidence of long-term pain for which acute postsurgical pain is an established risk factor. Therefore, the genetic basis of elevations in acute postsurgical pain after thoracotomy was investigated. METHODS: A cohort of thoracotomy patients participating in an ongoing trial of outcomes after cancer were enrolled. A standard combined general and epidural anesthetic and surgical approach were used. All patients received a standardized postoperative epidural analgesia regimen. Postoperatively, pain scores were determined and blood was collected for genotyping. Our a priori hypothesis was that variability of genes involved in nociception and analgesic therapy would predict pain score ≥3 of 10 on the third postoperative day. RESULTS: Ninety patients with pain and genotyping data on postoperative day 3 were examined. We found no association between markers in COMT, COX1, COX2, and TRPV1 and postoperative pain. We demonstrated several statistically significant associations with 4 single nucleotide polymorphism markers in OPRM1 (odds ratio, 95% confidence intervals): rs634479 (0.4, 0.17, 0.97), rs499796 (0.35, 0.13, 0.92), rs548646 (0.47, 0.23, 0.97), and rs679987 (0.1, 0.01, 0.84). From these, we inferred 2 haplotype blocks in OPRM1 where both had a frequency of 9% and P=0.03 and 0.04. Previously published functional single nucleotide polymorphisms in OPRM1 and COMT were not associated with increased pain on the third postoperative day. DISCUSSION: We identified previously unpublished haplotypes of the OPRM1 receptor that predicted increases in self-reported pain on the third postoperative day after thoracotomy. These findings require replication and further refinement before their impact on patient care can be determined.
OBJECTIVES: The mechanism whereby acute postsurgical pain can persist and become chronic remains unknown. Thoracotomy is a common procedure with a high incidence of long-term pain for which acute postsurgical pain is an established risk factor. Therefore, the genetic basis of elevations in acute postsurgical pain after thoracotomy was investigated. METHODS: A cohort of thoracotomy patients participating in an ongoing trial of outcomes after cancer were enrolled. A standard combined general and epidural anesthetic and surgical approach were used. All patients received a standardized postoperative epidural analgesia regimen. Postoperatively, pain scores were determined and blood was collected for genotyping. Our a priori hypothesis was that variability of genes involved in nociception and analgesic therapy would predict pain score ≥3 of 10 on the third postoperative day. RESULTS: Ninety patients with pain and genotyping data on postoperative day 3 were examined. We found no association between markers in COMT, COX1, COX2, and TRPV1 and postoperative pain. We demonstrated several statistically significant associations with 4 single nucleotide polymorphism markers in OPRM1 (odds ratio, 95% confidence intervals): rs634479 (0.4, 0.17, 0.97), rs499796 (0.35, 0.13, 0.92), rs548646 (0.47, 0.23, 0.97), and rs679987 (0.1, 0.01, 0.84). From these, we inferred 2 haplotype blocks in OPRM1 where both had a frequency of 9% and P=0.03 and 0.04. Previously published functional single nucleotide polymorphisms in OPRM1 and COMT were not associated with increased pain on the third postoperative day. DISCUSSION: We identified previously unpublished haplotypes of the OPRM1 receptor that predicted increases in self-reported pain on the third postoperative day after thoracotomy. These findings require replication and further refinement before their impact on patient care can be determined.
Authors: Inés Rodriguez; Blythe H Philips; Emily L Miedel; Lauren A Bright; Philip C LaTourette Ii; Anthony J Carty; Walter R Witschey; Robert C Gorman; Joseph H Gorman Iii; James O Marx Journal: J Am Assoc Lab Anim Sci Date: 2019-08-26 Impact factor: 1.232
Authors: Jennifer S Gewandter; Robert H Dworkin; Dennis C Turk; John T Farrar; Roger B Fillingim; Ian Gilron; John D Markman; Anne Louise Oaklander; Michael J Polydefkis; Srinivasa N Raja; James P Robinson; Clifford J Woolf; Dan Ziegler; Michael A Ashburn; Laurie B Burke; Penney Cowan; Steven Z George; Veeraindar Goli; Ole X Graff; Smriti Iyengar; Gary W Jay; Joel Katz; Henrik Kehlet; Rachel A Kitt; Ernest A Kopecky; Richard Malamut; Michael P McDermott; Pamela Palmer; Bob A Rappaport; Christine Rauschkolb; Ilona Steigerwald; Jeffrey Tobias; Gary A Walco Journal: Pain Date: 2015-07 Impact factor: 7.926
Authors: Cielito C Reyes-Gibby; Jian Wang; Mary Rose T Silvas; Robert Yu; Sai-Ching J Yeung; Sanjay Shete Journal: BMC Genet Date: 2016-02-13 Impact factor: 2.797
Authors: Owoicho Adogwa; Aladine A Elsamadicy; Victoria D Vuong; Ankit I Mehta; Raul A Vasquez; Joseph Cheng; Carlos A Bagley; Isaac O Karikari Journal: Global Spine J Date: 2017-05-31