Pharmacogenetic Approaches in Personalized Medicine for Postoperative Pain Management

Abstract

Despite technical and pharmacological advancements in recent years, including optimized therapies and personalized medicine, postoperative pain management remains challenging and sometimes undertreated. This review aims to summarize and update how genotype-guided therapeutics within personalized medicine can enhance postoperative pain management. Several studies in the area have demonstrated that genotype-guided therapy has the ability to lower opioid consumption and improve postoperative pain. Gene mutations, primarily OPRM1, CYP2D6, CYP2C9, COMT and ABCB1, have been shown to exert nuanced influences on analgesic response and related pharmacological outcomes. This review underscores the integration of pharmacogenetic-guided personalized medicine into perioperative care, particularly when there is uncertainty regarding opioid prescriptions. This approach leads to superior outcomes in terms of postoperative pain relief and reduced morbidity for numerous patients.

Keywords: drug response; genetic markers; pain management; personalized medicine; pharmacogenetics; postoperative pain; therapeutic efficacy.

Figure 1

Differences between conventional and personalized analgesic approaches: Conventional approach: The same protocol in a conventional analgesic regimen can elicit different responses in different individuals. Personalized: In a programmed surgery, after an informed consent, buccal swabs provide a convenient means of obtaining a DNA sample. Following the collection, the DNA is extracted. Based on selected genes, the tailored analgesic protocol is developed to suit individual needs and optimize pain management. Legend: two green faces represent none to mild pain; two yellow faces represent mild to moderate pain, and two red faces represent moderate to severe pain.

Figure 2

PRISMA flowchart.