Pharmacogenomics of Methadone in Spine Fusion Surgery
Status:
Withdrawn
Trial end date:
2015-01-01
Target enrollment:
Participant gender:
Summary
The overall objective is to develop a patient oriented research program to efficiently
evaluate the effects of pharmacogenetic variants on the dose-response relationships and
safety of opioids and non-opioid analgesics. If an opioid regimen can be created that
produces excellent opioid analgesia with minimal toxicity related to supratherapeutic opioid
concentrations (i.e., ventilatory depression), other non-opioid analgesics (i.e.,
gabapentin/pregabalin, ketamine, lidocaine, cyclooxygenase inhibitors, etc.) that may
decrease preoperative opioid requirements can be more efficiently and safely evaluated. These
interventions may limit the opioid related toxicities related to effect site concentrations
that are below those required when opioids are the predominant analgesic, such as opioid
related ileus. Methadone's slow elimination clearance and limited pharmacokinetic drug-drug
interactions make it an attractive perioperative opioid. The first step towards personalized
opioid analgesia is to determine the effect of common pharmacogenetic variants that affect
either methadone metabolism (CYP2B6) or opioid elimination.