The Pharmacogenetics of Opioid Treatment for Post-operative Pain Management

Opioids are among the most commonly prescribed medications, internationally. Current evidence suggests that variability in opioid analgesia can be attributed to genetic factors. The association of ten opioid-related genetic variants and opioid analgesia was investigated in a sample of 72 healthy participants experiencing pain after the removal of wisdom teeth. Percent change in pain severity and pain interference was assessed over a seven-day post-operative period using a pain questionnaire. Data were analyzed using non-parametric tests. In this cohort, 58% were female, 42% were male, and the mean age was 23 years of age. Participants were prescribed codeine (47%), tramadol (3%), oxycodone (1%), morphine (36%), or hydromorphone (13%). The OPRD1 gene T921C variant (p=0.02), the ABCB1 gene C3435T variant (p=0.01), and CYP2D6 metaboliser status (p=0.01) were associated with opioid analgesia. These findings suggest involvement of these variants in opioid response, which may be helpful in optimizing individualized therapy for post-operative pain.M.Sc