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The present study aimed to investigate the effect of cytochrome P450 3A4(CYP3A4)*18B polymorphisms and the interaction of the µ opioid receptor gene (OPRM1)A118G and CYP3A4*18B polymorphisms on postoperative fentanyl analgesia in ChineseHan patients undergoing radical gastrectomy. In total, 97 patients scheduled toundergo radical gastrectomy under general anesthesia were enrolled in this study.Post‑operative patient‑controlled intravenous analgesia of fentanyl was administeredas analgesia up to 48 h following surgery. Venous blood (2 ml) was obtained fromeach patient to measure the OPRM1 A118G and CYP3A4*18B genotypes. The differencesin fentanyl consumption and adverse effects were compared among the genotypesat 24 and 48 h following surgery. In the first 48 h following surgery, patientsin the CYP3A4*18B/*18B group consumed significantly less fentanyl compared withpatients in the *1/*1 group (P=0.032). With regards to the joint genetic effect,during the 48‑h period, patients with AA and *1*18B polymorphisms received fewerfentanyl doses compared with those with AG and *1*1 (P=0.049), while patientswith AG and *1*18B polymorphisms received significantly fewer fentanyl doses comparedwith those with AG and *1*1 (P=0.010), and patients with *18B*18B polymorphismsreceived significantly fewer fentanyl doses compared with those with AA and *1*1(P=0.024) or those with AG and *1*1 polymorphisms (P=0.006). No correlation betweenOPRM1 A118G and CYP3A4*18B and postoperative nausea, vomiting and dizziness wasfound. Results demonstrated that 48 h following surgery, patients with the CYP3A4*18B/*18Bgenotype required less fentanyl than patients with the CYP3A4*1/*1 genotype tocontrol pain. Additionally, the combined genotype of CYP3A4*18B and OPRM1 A118Gmay affect fentanyl doses administered for pain control, but not postoperativenausea, vomiting and dizziness.

Effect of CYP3A4*18B polymorphisms and interactions with OPRM1 A118G on postoperative fentanyl requirements in patients undergoing radical gastrectomy