The influence of cytochrome p-450 gene polymorphisms on the tramadol postoperative analgesia effectiveness

Abstract

The effectiveness of postoperative analgesia may be determined by genetic characteristics of patients that affect the pharmacodynamics and pharmacokinetics of drugs. In particular, as a result of the metabolism of tramadol by isoenzyme of cytochrome P-450 is formed O-desmethyltramadol having higher affinity to mu-opioid receptors. The paper explored the effectiveness of analgesia based on tramadol in 48 patients after endoscopic gynecological surgery depending on the presence/absence of polymorphisms of CYP2D6 gene.It was found that 15 patients with polymorphisms С100Т and G1846A had more intensive postoperative pain, which was accompanied by activation of the sympathetic nervous system. Determination of these polymorphisms may be useful to select the optimal postoperative analgesia.