Pharmacogenetics and Pharmacokinetics of Oxycodone to Personalize Postoperative Pain Management Following Thoracic Surgery in Adults
OpalGenix, Inc
Summary
The proposed research is an important extension of an ongoing perioperative personalized analgesia and intravenous opioid pharmacogenetic research. This research focuses on two of the most commonly used oral opioid analgesics, oxycodone, and methadone, in adults following thoracic surgery. Major inpatient thoracic surgeries (TS) for lung disease are common and extremely painful surgeries and are associated with sever post-surgical pain, high incidence of chronic post-surgical pain (CPSP), excess opioid use, costly immediate postoperative opioid adverse events (AEs), and long hospital stays. This study is aiming to develop proactive risk prediction algorithms for precision surgical pain relief in adult TS patients through comparison of actual clinical outcomes with standard of care to predicted outcomes based on personalized risk assessments.
Description
Risks associated with post-TS pain and opioids. Opioids are still widely used to manage acute surgical pain and remain a core component of enhanced recovery after surgery protocols (ERAS) for painful TS. With current approaches that incorporate ERAS protocols, half of TS patients still suffer from uncontrolled severe surgical pain and significant adverse opioid effects due to opioids' narrow therapeutic indices and unpredictable inter-individual variations in pain perception and opioid responses. Risks associated with perioperative opioid use include immediate risks (life-threatening respirato…
Eligibility
- Age range
- 18–99 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * \>18 years * American Society of Anesthesiologists (ASA) Physical Status 1, 2, 3 * Undergoing thoracic surgery (TS; pneumonectomy, lobectomy and segmentectomy) Exclusion Criteria: * Children (\<18 years) * Pregnant women * American Society of Anesthesiologists (ASA) Physical Status 4 or above * Non-English speaking * Outpatient surgery * Concomitant additional surgical procedures * Significant liver and kidney dysfunction * Significant cardiorespiratory compromise * Patients with polysubstance use (e.g., cocaine, marijuana, amphetamine, etc.)
Locations (4)
- UPMC Presbyterian HospitalPittsburgh, Pennsylvania
- UPMC Mercy HospitalPittsburgh, Pennsylvania
- UPMC Shadyside HospitalPittsburgh, Pennsylvania
- UPMC Passavant HospitalPittsburgh, Pennsylvania