• Ulrich H Frey, Christoph Schnee, Marc Achilles, Marie-Therese Silvanus, Joachim Esser, and Jürgen Peters.
• From the Klinik für Anästhesiologie und Intensivmedizin (UHF, CS, MA, M-TS, JP), and Zentrum für Augenheilkunde, Klinik für Erkrankungen des vorderen Augenabschnitts, Universität Duisburg-Essen & Universitätsklinikum, Essen, Germany (JE).
• Eur J Anaesthesiol. 2016 Feb 1; 33 (2): 84-9.

BackgroundThe risk of developing postoperative nausea and vomiting (PONV), apart from conventional risk factors, probably includes a genetic background.ObjectivesWe examined the association of the DRD2 TaqIA polymorphism with PONV in a high-risk cohort of patients.DesignA prospective, double-blind observational trial.SettingSingle-centre primary care in Western Germany.PatientsA total of 306 patients undergoing elective strabismus surgery under anaesthesia with etomidate/alfentanil/mivacurium (induction) and sevoflurane in air (maintenance).Main Outcome MeasuresNausea as well as retching/vomiting was recorded for 24 h postoperatively. The DRD2 TaqIA polymorphism (rs1800497) was genotyped using a Taqman assay and the relationship between DRD2 TaqIA polymorphism and PONV was examined by univariate and multivariate analysis.ResultsRegarding known risk factors for developing PONV, no patient with the A1A1 genotype (n = 15) had a history of PONV, while A1A2 carriers (n = 115) and A2A2 carriers (n = 176) had a history of PONV in 22.6 and 10.8% of patients, respectively (P = 0.005). Overall, the incidence of nausea was 40.1% and the incidence of vomiting/retching was 32.7%. Univariate analysis showed that postoperative nausea was not associated with TaqIA genotypes, but the incidence of retching/vomiting in A1A2 and A2A2 genotypes was more than 34% compared with zero in A1A1 genotypes (P = 0.022). Age, sex, smoking status and a history of PONV were independent predictors for nausea as well as for retching/vomiting, as expected, while DRD2 TaqIA polymorphism showed no independent significant impact.ConclusionIn a white cohort, the TaqIA A2 allele is significantly associated with a history of PONV, which may explain the increased incidence of PONV but has no further independent influence.Trial RegistrationGerman registry of clinical trials identifier: DRKS00005681.

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