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OPRM1 A118G Polymorphism and Ondansetron Efficacy for Postoperative Nausea and Vomiting in Laparoscopic

Xu Zhao1, Qingqing Yu2, Guanling Yu2

  • 1Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.

Therapeutics and Clinical Risk Management
|January 1, 2026
PubMed
Abstract

Insights

The OPRM1 A118G gene variant increases the risk of postoperative nausea and vomiting (PONV). Ondansetron effectively reduces PONV, particularly in patients with this genetic susceptibility.

Area of Science:

  • Pharmacogenetics
  • Anesthesiology
  • Gastroenterology

Background:

  • Postoperative nausea and vomiting (PONV) is a common complication.
  • The OPRM1 A118G polymorphism may influence PONV susceptibility.
  • Ondansetron is a standard PONV prophylaxis, but its efficacy relative to OPRM1 A118G is unclear.

Purpose of the Study:

  • To investigate the impact of the OPRM1 A118G polymorphism on PONV risk.
  • To evaluate the efficacy of Ondansetron in patients with varying OPRM1 A118G genotypes.

Main Methods:

  • Retrospective cohort study of patients undergoing laparoscopic gynecological surgery.
  • Propensity score matching for confounder adjustment.
  • Genotyping for OPRM1 A118G polymorphism via PCR and sequencing.
  • Assessment of PONV incidence and severity using Visual Analog Scale (VAS).

Main Results:

  • Ondansetron significantly reduced PONV incidence compared to controls within 2 hours (38.82% vs 56.98%) and 2-24 hours (8.24% vs 19.77%).
  • The OPRM1 A118G polymorphism, particularly AG/GG genotypes, was linked to higher PONV risk in the control group.
  • In the Ondansetron group, the genetic association with PONV was significant within the first 2 hours.

Conclusions:

  • The OPRM1 A118G polymorphism increases early PONV risk, especially with the G allele, potentially due to reduced μ-opioid receptor sensitivity.
  • Ondansetron effectively mitigates PONV incidence and severity, demonstrating particular benefit in genetically susceptible individuals.
Keywords:
A118GOPRM1ondansetronpostoperative nausea and vomiting

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