To explore the epigenetic mechanism of postoperative analgesia and side effect induced by μ-opioid Receptor Agonists presented with sufentanil among general population.
Patients were interviewed the day before surgery, and taught about the use of PCA pump and VAS. Pressure pain threshold(PPT) and pressure pain tolerance(PTO) were collected before surgery. Dexmedetomidine1μg/Kg,sufentanil 0.5μg/Kg, propofol 2mg/Kg and rocuronium 0.6mg/Kg were given intravenously for induction. Anesthesia was maintained with inhalation of 1% sevoflurane and infusion of remifentanil (0.2-0.4ug/kg/min) and propofol (6-10mg/kg/h). Aterial blood pressure(ABP),central venous pressure(CVP),SPO2, HR,ETCO2,T and Narcotrend were monitored. Before incision, parecoxib 40mg was given intravenously, and PCA with sufentanil 1ug/ml was started immediately after surgery, suing a controlled infusion pump. The pump was programmed to use a loading dose of 2ml, background infusion at 2m/h, PCA dose of 1ml, lockout time of 10min, and maximal dose of 12ml with 1 h period. VAS(static), VAS(dynamic), Ramssay, HR, NBP, SpO2, PCA pressing frequency, PCA comsumption were recorded 6h, 12h, 24h, 48h after surgery. Side effects such as nausea, vomiting, respiratory depression; pruritus; abdominal distention; urinary retention and dizziness were also recorded, and corresponding treatment were given. EDTA anti-coagulated blood was collected from a central venous catheter during the operation. Genomic DNA was extracted from the blood samples, and characteristics and degree of DNA methylation of the gene OPRM1 were analysed.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SCREENING
Masking
NONE
Enrollment
100
Patients received intravenous sufentanil 0.5μg/kg for induction,and received PCA after surgery with sufentanil 1ug/ml using a controlled infusion pump, which was programmed to use a loading dose of 2ml, background infusion at 2m/h, PCA dose of 1ml, lockout time of 10min, and maximal dose of 12ml within 1 hour period.
Patients received intravenous dexmedetomidine 1μg/Kg for induction.
Patients received intravenous propofol 2mg/Kg for induction, and received intavenous pump of propofol (0.3-0.6mg/kg/h) for maintenance.
Department of Anaesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, China
RECRUITINGQuantification of methylation in CpG islands located in gene OPRM1
EDTA anti-coagulated blood was collected before induction. Genomic DNA was extracted according to the manufacturer's protocol, and CpG islands in the OPRM1 gene region were identified by CpG Island Explorer 2.0 software. Quantification of DNA methylation of all CpG sites from position +528 to +1649 in CpG islands was analysed.
Time frame: 3 months
Pressure pain threshold (PPT) and pressure pain tolerance (PTO)
Patients' Pressure pain threshold(PPT) and pressure pain tolerance(PTO) in Kg/cm2 were measured before surgery using electronic pressure algometer (YISIDA-DS2, Hongkong, China).
Time frame: 1 day
Sex
Patients' sex (male or female) was recorded before surgery.
Time frame: 1 day
Age
Patients' age in years was recorded before surgery.
Time frame: 1 day
Weight
Patients' weight in kilograms was recorded before surgery.
Time frame: 1 day
Height
Patients' height in meters was recorded before surgery.
Time frame: 1 day
History of smoking
Patients' history of smoking (yes or no) was recorded before surgery.
Time frame: 1 day
VAS (static) and VAS (dynamic)
Patients' VAS(static) and VAS(dynamic) score (range 0-10) were recorded at time point of 6hours, 12hours, 24hours, 48hours after surgery.
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Patients received intravenous rocuronium 0.6mg/Kg for induction.
Patients received inhalation of sevoflurane (1-2%) for maintenance.
Patients received intavenous pump of remifentanil (0.1-0.2ug/kg/min) for maintenance.
Parecoxib 40mg was given single intravenously before incision.
Time frame: 6hours, 12hours, 24hours, 48hours after surgery.
Ramssay
Patients' Ramssay score (range 1-6) was recorded at time point of 6hours, 12hours, 24hours, 48hours after surgery.
Time frame: 6hours, 12hours, 24hours, 48hours after surgery.
Heart rate (HR)
Patients' HR in bpm was recorded at time point of 6hours, 12hours, 24hours, 48hours after surgery.
Time frame: 6hours, 12hours, 24hours, 48hours after surgery
Blood pressure (BP)
Patients' BP in mmHg was recorded at time point of 6hours, 12hours, 24hours, 48hours after surgery.
Time frame: 6hours, 12hours, 24hours, 48hours after surgery.
Pulse oxygen saturation (SpO2)
Patients' SpO2 in percent was recorded at time point of 6hours, 12hours, 24hours, 48hours after surgery.
Time frame: 6hours, 12hours, 24hours, 48hours after surgery.
PCA pressing frequency
Patients' PCA pressing frequency in time was recorded at time point of 6hours, 12hours, 24hours, 48hours after surgery.
Time frame: 6hours, 12hours, 24hours, 48hours after surgery
PCA consumption
Patients' PCA consumption in ml was recorded at time point of 6hours, 12hours, 24hours, 48hours after surgery.
Time frame: 6hours, 12hours, 24hours, 48hours after surgery
Side effects
Side effects such as nausea, vomiting, respiratory depression, pruritus, abdominal distention, urinary retention and dizziness (yes or no) were recorded at time point of 6hours, 12hours, 24hours, 48hours after surgery, and corresponding treatment were given.
Time frame: 6hours, 12hours, 24hours, 48hours after surgery