Opioid receptor mu 1 (OPRM1) A118G polymorphism (rs1799971) and postoperative nausea and vomiting

摘要

Background: OPRM1-A118G polymorphism (A > G, rs1799971) is associated with interindividual variability in both response to postoperative pain and opioid treatment. The aim of this meta-analysis is to identify the predictive strength in the current literature of OPRM1-A118G polymorphism to postoperative anesthetic reactions, including nausea, vomiting, pruritus and dizziness. Methods: PubMed, EMBASE, Cochrane Library, Web of Knowledge, Google Scholar and CNKI database were searched to find gene-association researches exploring the impacts of OPRM1-A118G polymorphism on postoperative side effects (time: up to July 2016). Odd ratios (ORs) with 95% confidence intervals (95% CIs) were estimated in allele model, homozygote model, heterozygote model, dominant model and recessive model. Sensitivity analysis and potential bias were also assessed. Results: 137 articles were retrieved from databases. 17 eligible studies, including 4690 patients were considered in the meta-analysis. The ORs with 95% CIs of postoperative nausea, vomiting, nausea and vomiting (PONV), pruritus and dizziness in the five genetic models mentioned above were determined. Postoperative vomiting was significantly associated with OPRM1-A118G polymorphism in homozygote (OR: 0.422; 95% CI: 0.254, 0.701; P = 0.001), dominant (OR: 0.765; 95% CI: 0.592, 0.987; P = 0.040) and recessive (OR: 0.439; 95% CI: 0.268, 0.717; P = 0.001) models. The 118G allele was associated with a reduced risk of vomiting. No other associations were detected. There was no evidence of publication bias. Conclusions: OPRM1-A118G polymorphism (A > G) is associated with a reduced risk of postoperative vomiting, but not nausea, pruritus and dizziness. The results should be interpreted with caution due to limited sample and possible heterogeneity between the included studies. Well-designed and large-scale studies are necessary to confirm our results.