• Guangyou Duan, Guifang Xiang, Shanna Guo, Yuhao Zhang, Ying Ying, Penghao Huang, Hua Zheng, Mi Zhang, Ningbo Li, and Xianwei Zhang.
• Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
• Pain Physician. 2016 Jan 1; 19 (1): E151-62.

BackgroundThe SCN9A gene product is a critical component in human pain perception. Recent studies found that single-nucleotide polymorphisms (SNPs) in this gene contributed to the risk and severity of common pain phenotypes.ObjectivesIn this study, we aimed to assess the use of SCN9A SNP screening for predicting postoperative pain.Study DesignA retrospective assessment of patients who underwent gynecological laparoscopic surgery.SettingDepartment of anesthesiology, a teaching hospital, in a medical college, major metropolitan city, China.MethodsTwenty-nine candidate and tag SCN9A SNPs were analyzed in this study. Four hundred twenty-one patients who underwent gynecological laparoscopic surgery and refused postoperative patient controlled analgesia (PCA) were recruited and completed the study protocol. An additional 578 patients who voluntarily received PCA treatment were included for verification. Postoperative pain intensity was evaluated in all patients using numerical rating scale (NRS), and for patients receiving PCA analgesic requirements were also recorded.Outcomes AssessmentThe outcome was assessment of postoperative pain NRS and PCA analgesic requirements.ResultsTen different SCN9A SNPs exhibited significant associations with postoperative pain intensity, the incidence of severe postoperative pain, and postoperative PCA requirement. Of the candidate SCN9A SNPs, there was a statistically significant correlation between SNP rs6746030 and higher maximum NRS scores during the postoperative follow-up of non-PCA patients (P < 0.05). Furthermore, there was a significant association between the tag SNP rs4286289 and both increased postoperative maximum NRS scores (P < 0.05) and higher incidences of severe postoperative pain (P < 0.05) in non-PCA patients. Meanwhile, in PCA patients, rs4286289 exhibited the strongest association (P = 0.001) with increased requirements for postoperative analgesics, which indirectly strengthened the significant association between this SNP and higher postoperative pain.LimitationsThe limitations of this study include that it is an assessment of only Chinese women scheduled for gynecological laparoscopic surgery.ConclusionThe current study provides evidence that postoperative pain was affected by SCN9A variability in gynecological patients. Notably, our results provide the first indication that SCN9A SNP rs4286289 can be used as a predictor for hypersensitivity to postoperative pain.

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