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Risk factors for respiratory depression in postoperative orthopedic trauma patients

Pennett, Andrea (2014) Risk factors for respiratory depression in postoperative orthopedic trauma patients. Undergraduate Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Respiratory depression is a serious and potentially lethal adverse effect of opioid medications that must be considered to achieve safe opioid pain management in clinical practice. The patient demographics; age, sex, height, weight, body mass index, smoking status, race, amount of opioid received in the operating room, amount of opioid received in the post anesthesia care unit (PACU), sedation score postoperatively, American Society of Anesthesiologists (ASA) Physical Status, and genetic variants from identified candidate genes; OPRM1, ABCB1, COMT, and CYP2D6 were potential risk factors that were analyzed for association with opioid induced respiratory depression after surgery for orthopedic trauma.
A sample of 152 subjects aged 18-70 that received surgeries for orthopedic trauma were included in this study. Subject characteristics data were collected from both subject reports and medical records. Data regarding respiratory rate postoperatively was collected in the post anesthesia care unit at 15 and 45 minutes postoperatively. DNA extraction was performed with saliva samples from the subjects. Sequencing was performed using Big Dye Cycle Sequencing reagents to determine OPRM1 genotype. Taqman allele discrimination was used to genotype ABCB1, COMT, and CYP2D6 genes.The patient characteristics ASA physical status and sedation score were associated with differences in respiratory rate at 15 and 45 minutes postoperatively. Differences in subject genotype on the ABCB1 gene single nucleotide polymorphism (SNP) (rs1045642) were associated with differences in respiratory rate 45 minutes postoperatively. CYP2D6 metabolizer group differences were associated with difference in respiratory rate at 15 minutes postoperatively.This study provided evidence in support of the use of ASA Physical Status, sedation score, ABCB1 SNP (rs1045642), and CYP2D6 metabolizer groups to identify individuals at increased risk for opioid induced respiratory depression postoperatively.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Pennett, Andreapennettandrea@gmail.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorHenker, Richardrhe001@pitt.eduRHE001
Committee MemberConley, Yvette P.yconley@pitt.eduYCONLEY
Committee MemberWesmiller, Susan Wattersswe100@pitt.eduSWE100
Committee MemberDai, Fengfeng.fed1@gmail.com
Date: 24 April 2014
Date Type: Publication
Defense Date: 9 April 2014
Approval Date: 24 April 2014
Submission Date: 17 April 2014
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 50
Institution: University of Pittsburgh
Schools and Programs: University Honors College
School of Nursing > Nursing
Degree: BSN - Bachelor of Science in Nursing
Thesis Type: Undergraduate Thesis
Refereed: Yes
Uncontrolled Keywords: Opioid,Respiratory Depression
Date Deposited: 24 Apr 2014 18:39
Last Modified: 15 Nov 2016 14:19
URI: http://d-scholarship.pitt.edu/id/eprint/21269

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