μ阿片受体a118g基因多态性对芬太尼静脉自控镇痛恶心呕吐的影响.doc

μ阿片受体A118G基因多态性对芬太尼静脉镇痛恶心呕吐的影响 袁静静 张卫 郑州大学第一附属医院麻醉科 【摘要】目的 观察μ阿片受体A118G基因多态性对妇科患者全麻术后芬太尼静脉镇痛恶心、呕吐的影响。20～50ASAⅠ或Ⅱ级。静脉注射咪、瑞芬太尼、异丙酚琥珀胆碱瑞芬太尼异丙酚，阿曲库铵术后芬太尼静脉自控镇痛-限制性片断长度多态性(PCR-RFLP)技术检测A118G基因多态性，根据基因型将病人分三组。ZHANG Wei, YUAN Jing-jing，KAN Quan-cheng, et al. Department of Anesthesiology，First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052,China 【Abstract】Objective: To evaluate the of OPRM1 A118G genetic polymorphism on postoperative nausea and vomiting induced by fentanyl intravenous analgesia in Chinese gynaecologic patients. Method: One hundred and sixty-five patients, aged 20-50 yr, ASAⅠorⅡ, scheduled for elective abdominal total hysterectomy or myomectomy with general anesthesia were enrolled. Anesthesia was induced with iv midazolam，remifentanil，propofol and succinylcholine. Remifentanyl 0.1～0.2 μg·kg-1·min-1, propofol 6～8 mg·kg-1·h-1 and iv atracurium were used for maintenance of anesthesia． Intravenous patient-controlled analgesia was provided postoperatively for satisfactory analgesia.The presence and scores of nausea and vomiting at 24h postoperatively were recorded and measured with rating scales.Pain and fentanyl consumption in the first 24 hours were measured with visual analog scale and recorded respectively.Genotyping of the A118G allele was conducted by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP). Patients were divided into three groups according to genotype. Results: Among the 165subjects, 80 women were wild homozygous (A/A), 63 were heterozygous (A/G), and 22 were mutant homozygous (G/G). Patients homozygous for 118G required more fentany to achieve adeqate pain relief compared with patients homozygous for 118 A and heterozygous in the first 24 hours. However, there were no statistically significant differences for the frequencies and scores of nausea and vomiting. Conclusion: The frequency of A118G allele is 32.4% in Chinese gynaecologic patients. There is no relationship between A118G polymorphism and