Home E-Weekly December 19, 2017

Could Genetics Play a Role in Post-Op Pain?

Published: December 18, 2017

HIDDEN GENES When it comes to pain control, physicians can now explore genetic factors that make some patients more prone to chronic pain after surgery.

Variation in pain-related genes could explain why millions of patients worldwide suffer from chronic post-operative pain. According to a study recently published in the medical journal of the American Society of Anesthesiologists (ASA), genetic variations comprise a higher percentage of chronic post-op pain reports (between 7 and 12%) than other clinical factors like age, gender and health history.

"Until now," says the study's lead researcher Matthew T.V. Chan, MD, "genetic variations associated with chronic postsurgical pain have not been well identified."

To gather their data, Dr. Chan and his colleagues sampled blood from 1,152 surgical patients, examining differences in 54 pain-related genes. A year after surgery, patients were contacted and asked about post-surgical pain, ranking the severity of their distress on a scale from 0 (no pain) to 10 (maximum pain) and explaining the level of its interference in their daily activities. 21% of patients reported any chronic post-op pain, and 33% of that pool reported the pain as severe. The team of researchers identified one gene in the nervous system called brain-derived neurotrophic factor (BDNF) as the closest in association with higher levels of chronic post-op pain.

"There are common genetic variations among people that may help to identify whether they are at high risk for developing chronic pain after surgery," remarks Dr. Chan.

The study raises awareness of the small portion of patients whose genetics might lie behind their lingering post-op pain. As dealing with chronic post-op pain has become a growing concern in recent years, an increased awareness for yet another contributing factor can only help providers identify at-risk patients and take preventative measures. How the study will affect treatment will likely depend on each case, patient and physician.

Joe Madsen

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