Novel associations between CYP2B6 polymorphisms, perioperative methadone metabolism and clinical outcomes in children

Methadone exhibits significant variability in clinical response. This study explores the genetic influence of variable methadone pharmacokinetics. This is a prospective study of methadone in children undergoing major surgery. genotyping, plasma methadone and metabolite levels were obtained. Clinical outcomes include pain scores and postoperative nausea and vomiting (PONV). poor metabolizers (*6/*6) had >twofold lower methadone metabolism compared with normal/rapid metabolizers. The incidence of PONV was 4.7× greater with variant. variants of SNP had 2.86-fold higher incidence of PONV compared with the wild variant ( ). Nominal associations between , and pain scores were observed. We have described novel associations between genetic variants and perioperative methadone metabolism, and associations with pain scores and PONV.