Does cytochrome 2D6 genotype affect the analgesic efficacy of codeine after ambulatory surgery? Prospective trial in 987 adults
Authors' conclusion
CYP2D6 genotype appears to be of minor importance for the analgesic efficacy of oral paracetamol-codeine combination therapy after ambulatory surgery in adult patients undergoing similar types of surgery as in the present study but it may affect the risk of constipation.
Study context
- Population
- Adults undergoing ambulatory surgery receiving oral paracetamol 1000 mg and codeine 60 mg premedication, then paracetamol-codeine at homeincluded in the analyses
- Participants
- 987 adults
- Exposure
- CYP2D6 metaboliser genotypes
- Poorn = 37
- Intermediaten = 264
- Normaln = 623reference
- Ultrarapidn = 63
- Outcome
- Codeine efficacy (postoperative pain, opioid consumption) and adverse effects
- Follow-up
- Day of surgery and following two postoperative days
Methodological detailsgenotype-based, single fixed codeine premedication dose
- Genotype-based
- Single fixed codeine premedication dose
Main finding
As reported in the abstract
Postoperative pain, opioid consumption, adverse effects
- CYP2D6 genotype not significantly associated with postoperative pain, opioid consumption or adverse effects of codeine, except constipation at home
Observational data: associations, not effects.
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Severe constipation at homePoor vs Normal · less severe constipation in poor metabolisers | 0.40 (0.20–0.80) | P = 0.009 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Does cytochrome 2D6 genotype affect the analgesic efficacy of codeine after ambulatory surgery? Prospective trial in 987 adults. Acta Anaesthesiol Scand. Published 14 November 2024. doi:10.
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