Abstract 【Objective】To investigate the relationship between cytochrome P450 2D6*10 (CYP2D6*10) gene polymorphism and the analgesic effect of tramadol in knee arthroplasty. 【Methods】A total of 345 patients who underwent total knee arthroplasty for the first time in our hospital from June 2016 to June 2021 were selected. CYP2D6*10 genotyping was performed by polymerase chain reaction (PCR) sequencing technology. The clinical data of patients were collected. The knee range of motion and visual analog pain score (VAS) at different time points after total knee arthroplasty were measured, and the adverse reactions were recorded to evaluate the analgesic effect of tramadol. The relationship between CYP2D6*10 gene polymorphism and intraoperative tramadol analgesic effect was evaluated by 2test or Fisher exact probability 【Results】PCR sequencing showed that 83 cases (24.06%) of CYP2D6*10 gene wild type (CC type), 165 cases (47.82%) of heterozygous mutation (CT type) and 97 cases (28.12%) of homozygous mutation (TT type). There was no significant difference in gender, age, height, BMI, operation time, tramadol use and adverse reactions among CC, CT and TT patients (P>0.05). Compared with CC type, CT and TT type patients had lower joint activity and higher VAS score at the same time, and the difference was statistically significant (P<0.05). 【Conclusion】CYP2D6*10 gene polymorphism is closely related to the analgesic effect of tramadol in knee arthroplasty, which may have certain guiding significance for its clinical application.
WANG Ya-ping,LIANG Hong. Relationship between CYP2D6*10 gene polymorphism and Analgesic Effect of Tramadol During Knee Arthroplasty[J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(3): 408-411.
[1] STARR J B, BACKONJA M, ROZET I. Beta-blocker use is associated with a reduction in opioid use 30 days after total knee arthroplasty[J].Pain Physician,2019,22(5):395-406.
[2] GOUDARZI T H, KAMALI A, YAZDI B, et al. Addition of dexmedetomidine, tramadol and neostigmine to lidocaine 1.5% increasing the duration of postoperative analgesia in the lower abdominal pain surgery among children: A double-blinded randomized clinical study[J].Med Gas Res,2019,9(3):110-114.
[3] WILLIAMS I S, GATCHIE L, BHARATE S B, et al. Biotransformation, using recombinant CYP450-expressing baker's yeast cells, identifies a novel CYP2D6.10(A122V) variant which is a superior metabolizer of codeine to morphine than the wild-type enzyme[J].ACS Omega,2018,3(8):8903-8912.
[4] WENDT F R, NOVROSKI N, RAHIKAINEN A L, et al. A pathway-driven predictive model of tramadol pharmacogenetics[J].Eur J Hum Genet,2019,27(7):1143-1156.
[5] FROST D A, SORIC M M, KAISER R, et al. Efficacy of tramadol for pain management in patients receiving strong cytochrome P450 2D6 inhibitors[J].Pharmacotherapy,2019,39(6):724-729.
[6] HOSSEINZADEH A Y, LAVASANI H, ROUINI M R. Gender dependency in streoselective pharmacokinetics of tramadol and its phase I metabolites in relation to CYP2D6 phenotype in Iranian population[J].Iran J Pharm Res,2018,17(2):767-782.
[7] 王旭, 高玉华, 郭斌, 等. 罗哌卡因复合舒芬太尼或地佐辛连续股神经阻滞在全膝关节置换术后镇痛中的应用[J].临床麻醉学杂志, 2016,32(3):258-261.
[8] 沈松坡, 翁习生, 冯宾. 全膝关节置换术后疼痛原因分析及疼痛预测模型的研究进展[J].中华骨科杂志, 2018, 38(17):1082-1088.
[9] 李新天, 王炜, 林进, 等. 改良鸡尾酒疗法对全膝关节置换术后疼痛控制的研究[J].中华骨与关节外科杂志, 2017,10(4):298-301.
[10] 李容杭, 李新宇, 何艳萍, 等. 全膝关节置换术后留置硬膜外镇痛泵与静脉自控镇痛泵镇痛效果比较[J].中华实验外科杂志, 2018, 35(3):577.
[11] 张晨, 班文瑞, 马骏, 等. 多模式镇痛治疗人工全膝关节置换术后疼痛及非甾体类抗生素使用量的临床研究[J].中华关节外科杂志(电子版), 2016,10(3):281-286.
[12] 徐纳新, 洪飚, 李岚, 等. CYP2D6*10基因多态性对曲马多与托烷司琼术后镇痛的影响[J].中国现代医生, 2014,52(28):48-50.
[13] 刘怡菲, 刘婷婷, 舒爱华. 不同剂量纳布啡复合曲马多对妇科手术全麻苏醒期镇痛效果的影响[J].临床麻醉学杂志, 2019,35(8):776-778.
[14] 刘芳, 张燕, 先小纲. CYP2D6*10遗传基因多态性对美托洛尔在围术期保护老年患者心脏功能的影响[J].重庆医科大学学报, 2014,39(6):895-898.
[15] 宋春雨, 芦树军, 常菲菲, 等. 细胞色素P450 2D6*10基因多态性对剖腹术后曲马多自控静脉镇痛的影响[J].临床麻醉学杂志, 2014,30(1):14-16.
2022, Vol. 39 
