Effects of genetic polymorphism of <italic style="font-style: italic">CYP3A4</italic> and <italic style="font-style: italic">CYP3A5</italic> on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery

Li GU; Li ZHOU; Yongshuai LI; Liyuan FENG; Xingtong CHEN; Xiangfeng LIU; Junxian QUAN; Peng LI; Jianteng GU

doi:10.16016/j.2097-0927.202110037

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Effects of genetic polymorphism of CYP3A4 and CYP3A5 on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery

Clinical Medicine | 更新时间：2026-02-13

- Effects of genetic polymorphism of CYP3A4 and CYP3A5 on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery
- Journal of Army Medical University Vol. 44, Issue 9, Pages: 930-934(2022)
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)：第一附属医院麻醉科
  2.400038 重庆，陆军军医大学(第三军医大学)：药学与检验医学系生药学与中药学教研室
- 作者简介：
- 基金信息：
  
  the Excellent Talents Foundation of Army Medical University(XZ2019-505-028)
- DOI：10.16016/j.2097-0927.202110037
  CLC： R394.5;R614.24;R971.2
- Received：10 October 2021，
  
  Revised：2021-12-08，
  
  Published：15 May 2022
- 稿件说明：
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Li GU, Li ZHOU, Yongshuai LI, et al. Effects of genetic polymorphism of CYP3A4 and CYP3A5 on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery[J]. Journal of Army Medical University, 2022, 44(9): 930-934.
DOI：

Li GU, Li ZHOU, Yongshuai LI, et al. Effects of genetic polymorphism of CYP3A4 and CYP3A5 on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery[J]. Journal of Army Medical University, 2022, 44(9): 930-934. DOI： 10.16016/j.2097-0927.202110037.

摘要

目的

探索不同

CYP3A4

和

CYP3A5

基因型患者腹腔镜术后舒芬太尼自控静脉镇痛(patient- control intravenous analgesia

PCIA)的差异。

方法

据

CYP3A4

、

CYP3A5

基因型将人群分为Ⅰ类(

CYP3A4

纯合突变，或

CYP3A4

杂合突变合并

CYP3A5

纯合突变)、Ⅱ类(

CYP3A4

杂合突变合并

CYP3A5

杂合突变)、Ⅲ类(

CYP3A4

野生型，或

CYP3A4

杂合突变合并

CYP3A5

野生型)。纳入2020年11月至2021年9月我院普外科和泌尿外科腹腔镜手术患者行观察性研究，于麻醉术前评估时采集患者口腔拭子行

CYP3A4

和

CYP3A5

基因检测，据其基因型并按男女1 ∶1比例，采用随机信封法和盲法分为A、B、C 3组，每组纳入30例患者，每组基因型待数据收集完毕并统计分析后，进行两次揭盲公布。3组患者术后均接受舒芬太尼PCIA。收集患者术后12、24和48 h的视觉模拟镇痛评分、Ramsay镇静评分、舒芬太尼累积用量、镇痛泵按压次数、恶心呕吐发生率等情况并进行分析。

结果

共采集口腔拭子标本256份，纳入A、B、C组的病例分别有23、24和27例完成本研究。数据采集完毕并统计分析后，公开A、B、C 3组患者基因型类型分别对应Ⅰ、Ⅱ、Ⅲ类人群。与A组比较，术后12 h时C组患者Ramsay评分显著升高(

＜0.05)，术后24、48 h时Ramsay评分3组间差异均无统计学意义。3类人群术后12、24、48 h的VAS评分、舒芬太尼用量、镇痛泵按压次数、恶心呕吐发生率差异均无统计学意义。

结论

CYP3A4

、

CYP3A5

基因多态性对腹腔镜手术后用舒芬太尼行术后PCIA无明显影响。

Abstract

Objective

To explore the differences of postoperative patient-controlled intravenous analgesia (PCIA) with sufentanil in the patients with different

CYP3A4

and

CYP3A5

genotypes after laparoscopic surgery.

Methods

According to

CYP3A4

and

CYP3A5

genotypes

the population are divided into class Ⅰ (

CYP3A4

homozygous mutation

CYP3A4

heterozygous mutation combined with

CYP3A5

homozygous mutation)

class Ⅱ (

CYP3A4

heterozygous mutation combined with

CYP3A5

heterozygous mutation)

and class Ⅲ (

CYP3A4

wild type

CYP3A4

heterozygous mutation combined with

CYP3A5

wild type). The patients undergoing laparoscopic surgeries in the departments of general surgery and urology of our first affiliated hospital from November 2020 to September 2021 were included in this prospective observational study. Oral swabs were collected for gene detection on

CYP3A4

and

CYP3A5

during the pre-anesthesia evaluation. According to their genotypes and 1 ∶1 ratio of men and women

they were randomly divided into group A

B and C by the randomized envelope and blind methods

with 30 patients in each group. The gene types of each group would be revealed through 2 steps. All patients in 3 groups received postoperative intravenous analgesia with sufentanil. The data

at 12

24 and 48 h after surgery were collected as the following: visual analog analgesia score (VAS)

Ramsay sedation score

cumulative dose of sufentanil

numbers of analgesic pump compressions

and incidence of postoperative nausea and vomiting.

Results

A total of 256 oral swab specimens were collected

and 23

and 27 patients in group A

B an

d C completed the study respectively. After data collection and statistical analysis

the genotype types of the patients in groups A

B and C were disclosed

corresponding to class Ⅰ

Ⅱ and Ⅲ populations respectively. Compared with class Ⅰ

the Ramsay score was significantly increased at 12 h after surgery in the patients from class Ⅲ (

0.05)

and there was no statistically significant difference in Ramsay score among the 3 populations at 24 and 48 h after surgery. There were no statistical differences in the VAS scores

cumulative dosage of sufentanil

number of analgesic pump compressions

and incidence of postoperative nausea and vomiting among the 3 groups 12

24 and 48 h after surgery.

Conclusion

Genetic polymorphisms of

CYP3A4

and

CYP3A5

have no significant effects on analgesic efficacy of postoperative PCIA with sufentanil after laparoscopic surgery.

关键词

Keywords

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⁰

Effects of genetic polymorphism of CYP3A4 and CYP3A5 on analgesic efficacy of postoperative intravenous analgesia with sufentanil in patients after laparoscopic surgery

DOI：10.16016/j.2097-0927.202110037

摘要

Abstract

关键词

Keywords

references