Background: The SCN9A gene product is a critical component in human pain perception. Recent
studies found that single-nucleotide polymorphisms (SNPs) in this gene contributed to the risk and
severity of common pain phenotypes.
Objectives: In this study, we aimed to assess the use of SCN9A SNP screening for predicting
postoperative pain.
Study Design: A retrospective assessment of patients who underwent gynecological laparoscopic
surgery.
Setting: Department of anesthesiology, a teaching hospital, in a medical college, major metropolitan
city, China.
Methods: Twenty-nine candidate and tag SCN9A SNPs were analyzed in this study. Four hundred
twenty-one patients who underwent gynecological laparoscopic surgery and refused postoperative
patient controlled analgesia (PCA) were recruited and completed the study protocol. An additional
578 patients who voluntarily received PCA treatment were included for verification. Postoperative
pain intensity was evaluated in all patients using numerical rating scale (NRS), and for patients
receiving PCA analgesic requirements were also recorded.
Outcomes Assessment: The outcome was assessment of postoperative pain NRS and PCA
analgesic requirements.
Results: Ten different SCN9A SNPs exhibited significant associations with postoperative pain
intensity, the incidence of severe postoperative pain, and postoperative PCA requirement. Of the
candidate SCN9A SNPs, there was a statistically significant correlation between SNP rs6746030 and
higher maximum NRS scores during the postoperative follow-up of non-PCA patients (P < 0.05).
Furthermore, there was a significant association between the tag SNP rs4286289 and both increased
postoperative maximum NRS scores (P < 0.05) and higher incidences of severe postoperative pain
(P < 0.05) in non-PCA patients. Meanwhile, in PCA patients, rs4286289 exhibited the strongest
association (P = 0.001) with increased requirements for postoperative analgesics, which indirectly
strengthened the significant association between this SNP and higher postoperative pain.
Limitations: The limitations of this study include that it is an assessment of only Chinese women
scheduled for gynecological laparoscopic surgery.
Conclusion: The current study provides evidence that postoperative pain was affected by SCN9A
variability in gynecological patients. Notably, our results provide the first indication that SCN9A SNP
rs4286289 can be used as a predictor for hypersensitivity to postoperative pain.
Key words: SCN9A, single-nucleotide polymorphisms, genotypic analysis, postoperative pain,
female patients, gynecological laparoscopic surgery, genetic markers for pain, predictors of
postoperative pain
External endometriosis, effectiveness of laparoscopic surgery
