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Opioid Requirements and Responses in Asians 

Opioid Requirements and Responses in Asians
Chapter:
Opioid Requirements and Responses in Asians
Author(s):

Anna Lee

, Simon K. C. Chan

, and Tony Gin

DOI:
10.1093/med/9780199768875.003.0026
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date: 24 September 2020

This chapter focuses on both acute and chronic pain (persistent pain beyond three months) after surgery in patients of Asian origin who have been treated with intravenous patient-controlled opioid analgesia. All studies reviewed in this chapter involved the use of intravenous patient-controlled analgesia (IV PCA) using morphine, fentanyl, or tramadol (a synthetic opioid). By restricting studies to the IV PCA technique, potential confounders are reduced because the between-subject variability in the demand for opioids from healthcare staff is eliminated and better quantitative data are obtained. We review the opioid requirements and responses of patients with polymorphisms of metabolizing enzymes and transporters that alter the pharmacokinetics of opioids, and polymorphisms of opioid receptors and opioid signalers that alter the pharmacodynamics. This genetic variation may contribute to the diverse opioid pharmacology (Figure 26.1). The implications for altered dose regimen and drug interactions with traditional Chinese herbal medicines are briefly discussed.

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