Abstract
Pain management in children remains a challenge. Postoperative pain assessment, which currently relies on behavioral and subjective scales, could be enhanced by the identification of single nucleotide polymorphisms effect on pain thresholds and opioid metabolism. This study explores the impact of nine SNPs-rs1799971, rs4680, rs4633, rs6269, rs4818 (with catechol-o-methyltransferase haplotypes), rs7832704, rs1801253, and rs1045642-on postoperative pain intensity, opioid requirements, coanalgesic use, C-reactive protein levels, and post-anesthesia care unit length of stay. This study involved 42 pediatric patients undergoing scoliosis correction surgery with postoperative sufentanil infusion. The genotyping was performed using real-time PCR with peripheral blood samples. Patients with the rs1801253 ADRB1 GG genotype showed significantly lower 24 h NRS pain ratings (p = 0.032) and lower sufentanil infusion rates at the level of statistical tendency (p = 0.093). Patients with the rs1205 CRP CT genotype had a shorter PACU length of stay (p = 0.012). In contrast, those with the rs1045642 ABCB1 GG genotype had a longer PACU stay by 0.72 h (p = 0.046). No significant associations were found for OPRM1 rs1799971, COMT, or ENPP2 SNPs. ADRB1 rs1801253may be a novel SNP indicating higher postoperative pain risk, while rs1205 CRP and rs1045642 ABCB1 could predict increased care requirements in PACUs. The ADRB1 rs1801253 SNP may also predict opioid demand. These results suggest SNPs should be considered in acute pain assessment.