{
  "abstract": "Background and Aims Pharmacogenetic testing for patients with a history of uncontrolled pain or opioid intolerance can inform personalized treatment plans. The aim of this study is to examine characteristics of patients undergoing pharmacogenetic testing through the HSS Perioperative Pain Service (POPS) and highlight information that pain management physicians utilize to inform decision making.Methods After IRB-approval, electronic medical record data were extracted for patients who were seen by POPS and underwent perioperative pharmacogenetic testing between April 6, 2019 and July 29, 2024. Descriptive statistics were used to summarize patient and case characteristics, test results and related pain management recommendations, incidence of severe acute postoperative pain, and postoperative opioid consumption.Results Twenty-four patients met inclusion criteria. Patient and case characteristics are described in table 1. Pharmacogenetic findings are summarized in table 2. Patients with a history of uncontrolled pain had genetic findings that aligned with their clinical presentation and aided in postoperative opioid type recommendations (e.g., hydromorphone or tapentadol for high-activity CYP3A4/5). Patients in which certain opioids did not provide analgesia were found to be OPRM1 A/G, DRD2 C/DEL, and/or COMT Met/Met, and patients with opioid-related adverse effects were confirmed to have altered opioid pharmacokinetics (e.g., intermediate, rapid, ultra-rapid metabolizers) mediated by CYP genes and ABCB1. For admitted patients, the frequency of severe acute pain (30.3%-50.0%) and median morphine milligram equivalents of opioid consumption (22.5–96.0) are reported in table 3. Most patients (66.7%) received opioid prescriptions at discharge that aligned with the preoperative pain consult recommendations, and were discharged primarily with hydromorphone (n=5, 20.8%) or tapentadol (n=6, 25.0%).Abstract OP58 Table 1Patient and case characteristicsAbstract OP58 Table 2Results of genomind® pharmacogenetic testsAbstract OP58 Table 3Inpatient frequency of severe postoperative pain (numeric rating scale pain score ≥7) and opioid consumptionConclusions Pharmacogenetic test results used for clinical decision making included pharmacokinetic genes of opioid metabolism and pharmacodynamic genes for sensitivity to medications. The cohort highlights sensitivity or tolerance of opioids based on genetic factors. Previous literature focuses on CYP2D6 metabolism; 12.5% of our cohort however were intermediate metabolizers.",
  "authors": [
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA",
        "Department of Anesthesiology, Weill Cornell Medicine, New York, USA"
      ],
      "name": "Faye Rim"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Weill Cornell Medicine, New York, USA",
        "Department of Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Dae Kim"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Maya Tailor"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "William Chan"
    },
    {
      "affiliations": [
        "Central Clinical Research Administration, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Dale Langford"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA",
        "Department of Anesthesiology, Weill Cornell Medicine, New York, USA"
      ],
      "name": "Alexandra Sideris"
    }
  ],
  "title": "OP58 Pharmacogenetics in perioperative pain management: an overview of patient characteristics, test results, and outcomes",
  "uid": "058a5e01-8b40-5a0c-a040-cd0dd5e58ef0"
}