Effects of CYP3A4*1G genetic polymorphism on pharmacokinetics of sufentanil in elder patients undergoing total hip replacement

doi:10.3877/cma.j.issn.1674-6880.2018.02.004

Abstract

Abstract:

Objective

To investigate the effects of CYP3A4*1G genetic polymorphism on pharmacokinetics of sufentanil in elder patients undergoing total hip replacement.

Methods

Totally 116 elder patients undergoing total hip replacement in Taizhou Central Hospital from January 2016 to August 2017 were enrolled. Patient controlled intravenous analgesia (PCIA) treatment was given after operation. Genotyping of CYP3A4*1G was carried out by pyrosequencing. The patients were assigned into 3 groups according to CYP3A4*1G genotypes: wild homozygote (the AA group, 69 cases), mutation heterozygote (GA group, 39 cases) and mutation homozygote (GG group, 8 cases). The visual analogue scale (VAS) at 6, 12, 24, 48 h, and sufentanil consumption and PCIA times at 48 h after surgery were recorded and compared.

Results

The VAS scores at 6, 12, 24, 48 h after surgery all showed significant differences among three groups (F=0.907, 0.192, 0.757, 0.256; all P > 0.05). The sufentanil consumption [(89.8 ± 0.8), (95.8 ± 0.5), (96.0 ± 0.4) μg; F=25.113, P<0.001] and PCIA times [(10.9 ± 2.0), (17.4 ± 4.5), (18.3 ± 3.7); F=35.227, P<0.001] at 48 h after surgery in the GG group were much lower than those in the AA and GA groups. However, there were no significant differences in above indicators between AA and GA groups (all P > 0.05).

Conclusion

Adjusting sufentanil doses in combination with patient genotypes can reduce drug usage in elder patients.

Key words: Polymorphism, single nucleotide, Sufentanil, Arthroplasty, replacement, hip, Dose-response relationship, drug, Aged

Lin Wang, Xianping Zhu, Yu Luo, Xuezheng Lin, Zhangquan Yao. Effects of CYP3A4*1G genetic polymorphism on pharmacokinetics of sufentanil in elder patients undergoing total hip replacement[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2018, 11(02): 90-93.

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References 17

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组别	例数	年龄（岁）	体质量（kg）	身高（cm）	BMI（kg/m²）	手术时间（min）	失血量（mL）
AA组	69	72 ± 5	61 ± 7	163 ± 7	22.9 ± 1.4	90 ± 15	251 ± 61
GA组	39	72 ± 4	60 ± 7	162 ± 6	22.9 ± 1.6	92 ± 12	233 ± 59
GG组	8	73 ± 4	62 ± 8	163 ± 10	23.1 ± 1.5	92 ± 9	240 ± 71
F值	?	0.304	0.810	0.761	1.065	0.397	1.506
P值	?	0.738	0.447	0.469	0.347	0.673	0.225

组别	例数	年龄（岁）	体质量（kg）	身高（cm）	BMI（kg/m²）	手术时间（min）	失血量（mL）
AA组	69	72 ± 5	61 ± 7	163 ± 7	22.9 ± 1.4	90 ± 15	251 ± 61
GA组	39	72 ± 4	60 ± 7	162 ± 6	22.9 ± 1.6	92 ± 12	233 ± 59
GG组	8	73 ± 4	62 ± 8	163 ± 10	23.1 ± 1.5	92 ± 9	240 ± 71
F值	?	0.304	0.810	0.761	1.065	0.397	1.506
P值	?	0.738	0.447	0.469	0.347	0.673	0.225

组别	例数	术后6 h	术后12 h	术后24 h	术后48 h
AA组	69	2.6 ± 0.8	2.9 ± 0.8	2.4 ± 0.6	1.9 ± 0.6
GA组	39	2.5 ± 1.0	3.0 ± 0.7	2.2 ± 0.7	1.9 ± 0.6
GG组	8	2.4 ± 0.7	2.9 ± 0.6	2.4 ± 0.9	2.0 ± 0.5
F值	?	0.907	0.192	0.757	0.256
P值	?	0.406	0.826	0.471	0.774

组别	例数	术后6 h	术后12 h	术后24 h	术后48 h
AA组	69	2.6 ± 0.8	2.9 ± 0.8	2.4 ± 0.6	1.9 ± 0.6
GA组	39	2.5 ± 1.0	3.0 ± 0.7	2.2 ± 0.7	1.9 ± 0.6
GG组	8	2.4 ± 0.7	2.9 ± 0.6	2.4 ± 0.9	2.0 ± 0.5
F值	?	0.907	0.192	0.757	0.256
P值	?	0.406	0.826	0.471	0.774

组别	例数	芬太尼消耗量（μg）	PCIA次数（次）
AA组	69	95.8 ± 0.5^a	17.4 ± 4.5^a
GA组	39	96.0 ± 0.4^a	18.3 ± 3.7^a
GG组	8	89.8 ± 0.8	10.9 ± 2.0
F值	?	25.113	35.227
P值	?	<0.001	<0.001

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