The
CYP2D6 gene encodes for an
enzyme that is involved in the metabolism of more than 25% of all medications, including many
opioids and
antiemetics. It may contribute to the risk of
postoperative nausea and vomiting (
PONV), a common surgical complication. However, little research has been conducted in this area. The purpose of this study was to explore the association of
CYP2D6 genotypes with
PONV in adult surgical
trauma patients. Data from 112 patients (28% female) with single extremity fractures, aged 18-70 years, were analyzed.
PONV was defined as present if patients reported
nausea, were observed
vomiting, or received medication for
PONV. Saliva samples collected for
DNA extraction and Taqman(®) allele discrimination and quantitative real time polymerase chain reaction (qRT-PCR) were used to collect genotype data that were then used to assign
CYP2D6 phenotype classification. The incidence of
PONV was 38% in the postanesthesia care unit and increased to 50% when assessed at 48 hr.
CYP2D6 classification results were 7 (6%) poor metabolizers, 34 (30%) intermediate metabolizers, and 71 (63%) extensive metabolizers. No ultrarapid metabolizers were identified. Patients who were classified as poor metabolizers had less
PONV and higher
pain scores. Gender and history of
PONV, but not smoking, were also significant risk factors. Findings suggest variability in
CYP2D6 impacts susceptibility to
PONV.