• Davide Seripa, Paola Latina, Andrea Fontana, Carolina Gravina, Monia Lattanzi, Maria Savino, Antonietta P Gallo, Giuseppe Melchionda, Stefano A Santini, Maurizio Margaglione, Massimiliano Copetti, Lazzaro di Mauro, Francesco Panza, Antonio Greco, and Alberto Pilotto.
• Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
• Pain Med. 2015 Oct 1; 16 (10): 2012-23.

ObjectiveTo investigate the role of CYP2D6 phenotype in the outcome of postoperative (PO) pain (POP) treatment.DesignLongitudinal cohort study. Open-label trial with post hoc analysis.SettingGeneral Hospital Surgery and Recovery Units.PatientsNinety unrelated Caucasians submitted to abdominal/thoracic surgery.InterventionsStandard multimodal POP treatment including opioids (tramadol) and nonsteroidal anti-inflammatory drugs (ketoprofen) at different dosages and infusion rates according to the predicted mild, moderate, or severe POP.Outcome MeasuresPain (Numeric Rating Scale-NRS) and sedation (Ramsay Sedation Scale-RSS) up to 24 hours after surgery. By genotyping 16 CYP2D6 alleles, the four CYP2D6 phenotypes poor metabolizer (PM), intermediate metabolizers (IM), extensive metabolizers (EM) and ultrarapid metabolizers (UM) were predicted.ResultsAs compared with the CYP2D6-EM phenotype, in the early PO time (30 min) a higher RSS mean score in IM was observed (P = 0.035). A suggestion towards higher mean score in PM (P = 0.091) and a minor mean score in UM (P = 0.091) was also detected. No difference in the outcome of pain across the CYP2D6 phenotypes was observed.ConclusionsIn respect to the normal CYP2D6 phenotype, our results suggested that slowly metabolizers (IMs and PMs) might have a major sedation, whereas more rapid metabolizers (UM) a minor sedation, in the early time after surgery. A minor role of CYP2D6 phenotype in PO analgesia may be suggested.Wiley Periodicals, Inc.

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