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postoperative pain management, the pain-relieving effectiveness of ketorolac
and tramadol can be predicted by CYP2D6 and CYP2C9.
As per the findings of a study, CYP2D6 and CYP2C9 gene polymorphisms can forecast the analgesic effectiveness of a combination of ketorolac and tramadol in people undergoing video laparoscopic cholecystectomy. This assessment was carried out to investigate the possible link of CYP2D6 and CYP2C9 polymorphisms with safety and efficacy of ketorolac and tramadol in postsurgery pain.
Overall, 107 participants were genotyped for CYP2C9 and CYP2D6 polymorphisms and underwent laparoscopic cholecystectomy. Assessment of postsurgery pain relief was done. Postoperative pain syndrome was examined utilizing McGill pain questionnaire and visual analogue scale (VAS). Dynamics of red blood counts evaluated adverse effects profile as a potential stimulus for eliciting gastrointestinal bleeding as per the global evaluation of triggers.
As noted, there was a substantial drop in pain in CYP2C9*2 carriers, based on VAS: after 12 h - by 1.5; after 24 h - by 1.1; after 36 h - by 1.05; after 48 h - by 0.7. The outcomes were not significant in CYP2C9*3 carriers. In carriers of CYP2D6*4, the pain syndromes were greater at all-time intervals. However, statistically reliable results were procured only after two h - by 1.01 and after 24 h - by 0.8.
For
NSAIDs, the profile of adverse effects was explored by the dynamics of
erythrocyte and hemoglobin indices. Considerable decline was witnessed in
relative difference in hemoglobin levels in CYP2C9*3 and CYP2C9*2 polymorphism
carriers by 2.2 and 1.7, respectively. CYP2C9 can anticipate gastrointestinal
bleeding risk, including those hidden to ketorolac, concluded the study
investigators.
Drug Metabolism and Personalized Therapy
The effect of CYP2D6 and CYP2C9 gene polymorphisms on the efficacy and safety of the combination of tramadol and ketorolac used for postoperative pain management in patients after video laparoscopic cholecystectomy
Andranik Alexandrovich Muradian et al.
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