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An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Catecholamine-o-methyltransferase polymorphisms are associated with postoperative pain intensity
Peter J Lee1, Patrick Delaney, John Keogh
1Departments of Anaesthesia and Intensive Care Medicine, University College Cork, Ireland. peterjohnlee@hotmail.com
The Clinical Journal of Pain
|September 16, 2010
Summary
Specific single nucleotide polymorphisms (SNPs) in the catecholamine-O-methyltransferase (COMT) gene were associated with reduced postoperative pain intensity. This finding offers insights into genetic factors influencing pain after surgery.
Area of Science:
- Pharmacogenetics
- Pain Research
- Genetics
Background:
- Single nucleotide polymorphisms (SNPs) in catecholamine-O-methyltransferase (COMT), μ-opioid receptor, and GTP cyclohydrolase 1 (GCH1) genes are linked to pain states.
- COMT gene polymorphisms are associated with experimental pain sensitivity and chronic pain.
- No perioperative associations between these SNPs and pain have been previously identified.
Purpose of the Study:
- To investigate the association between specific SNPs in COMT, μ-opioid receptor, and GCH1 genes and the development of postoperative pain.
- To examine the relationship between these genetic variations and pain intensity in patients undergoing third molar extraction.
Main Methods:
- A prospective observational clinical trial was conducted with 100 patients undergoing third molar extraction.
- Psychological and clinical parameters were measured.
- Patients were genotyped for SNPs within the GCH1, COMT, and μ-opioid receptor 1 genes.
Main Results:
- Persistent pain after 3 months was reported by 7.1% of patients.
- The GG genotype for COMT SNPs rs4818 or rs6269 was associated with adequate postoperative analgesia.
- Rare forms of COMT SNPs rs4818 and rs6269 correlated with lower postoperative pain intensity.
- GCH1 SNPs were associated with the duration of time until analgesia was not required in the first postoperative week.
Conclusions:
- This study provides early evidence of a significant association between a COMT gene SNP and a clinically relevant postoperative pain outcome.
- Genetic variations in COMT may influence individual responses to pain after elective surgery.
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