Association of ABCB1 C1236T Gene Polymorphisms With the Postoperative Analgesic Effects of Sufentanil and Morphine in Patients With Femoral Fractures.

Abstract

Purpose: This study aimed to investigate the association between the ABCB1 C1236T gene polymorphism and the analgesic effects of sufentanil and morphine in patients undergoing surgery for femoral fractures (FFs).

Design: An experimental, exploratory design was used.

Methods: 400 patients who underwent FF surgery were randomly assigned to two groups using a random number table method: the morphine group and the non-morphine group. In the morphine group, patients received an epidural injection of 1.5 mL of morphine hydrochloride (referred to as morphine) at the end of the surgery. In the non-morphine group, patients received 1.5 mL of 0.9 % normal saline (NS) solution. Postoperatively, all patients were administered sufentanil exclusively through an intravenous analgesic pump. Patients were observed for genetic polymorphisms, postoperative pain and adverse reactions.

Findings: A total of 369 patients participated in the study, with 185 in the morphine group and 184 in the non-morphine group. In the morphine group, there were 90 cases of the CC genotype, 90 cases of the CT genotype, and 5 cases of the TT genotype. In the non-morphine group, there were 84 cases of the CC genotype, 76 cases of the CT genotype, and 24 cases of the TT genotype. The genotype frequencies in both groups adhered to Hardy-Weinberg equilibrium. In the non-morphine group, patients with the CC genotype had significantly lower NRS scores on day 1 compared to those with CT and TT genotypes (P < 0.05). No significant differences were found in other indicators (P > 0.05). In the morphine group, no significant differences were observed among the three genotypes in terms of NRS scores (P > 0.05). Multiple linear regression analysis revealed that postoperative 1-day NRS score was associated with the time of onset of postoperative pain and the ABCB1 C1236T genotype (P < 0.05).

Conclusions: The ABCB1 C1236T gene polymorphism was a genetic factor influencing early postoperative pain in Han patients with FFs. However, epidural administration of morphine could mitigate the impact of this gene mutation on early analgesia induced by sufentanil.