Specific Aims: The complex nature of pain, composed of both subjective and objective components, makes its proper and effective management difficult for every patient. In many instances factors such as race/ethnicity, which affect culture distort the objective nature of self-reported pain levels. Management is further compounded by opioid analgesics, which exert a range of adverse affects that vary in presentation and intensity between individuals. Therefore research in genetics, particularly the OPRM1 gene, may expose more reliable and successful methods for individual pain management. This study sought to accomplish this goal by evaluating the following specific aims: 1) Describe the distributions of genotypes and alleles for the variants, A118G and C17T, 2) Evaluate the distributions of the genotypes for A118G and C17T between races/ethnicities, 3) Evaluate the distribution of self-reported pain scores by genotype, and 4) Evaluate the distribution of opioid use by genotype.
Methods: Eighty-three subjects were recruited from Presbyterian Hospital, University of Pittsburgh Medical Center. Variables such as race/ethnicity, pain report, and opioid use were collected from patient report or from the medical record. Genotypes were determined through DNA extraction from saliva samples.
Results: The proportions of C17T variant genotypes, CT and TT, were significantly higher in the African-American group as compared to the Caucasian group (p<.001). The pain scores at 15 minutes post-operatively were significantly lower in participants with either the CT and TT genotypes than participants having the CC genotype (p=.039). No significant differences between the genotypes, A118G and C17T, were found for other categories of race/ethnicity, self-reported pain levels, or amount of opioid use
Conclusions: The finding of higher proportions of the variant CT and TT genotypes in African-American patients relative to Caucasian patients is consistent with the literature. The findings of lower pain scores within the immediate post-operative time frame for those with CT and TT genotypes has not been as well documented in the literature and may support the need for further research in this area. Therefore this study does not support a change in practice for pain management, but it does provide the basis for further research into the SNPs of OPRM1, particularly C17T.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-08142009-152411 |
| Date | 21 August 2009 |
| Creators | Gowda, Indira |
| Contributors | Dr. Richard Henker, Dr. Yvette Conley, Dr. Susan M. Sereika, Dr. Colleen Dunwoody |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-08142009-152411/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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