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Anaesthesia Critical Care & Pain Medicine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 23 mai 2019
Doi : 10.1016/j.accpm.2019.04.012
Genetic contribution to PONV risk

Stefanie Klenke a, , Gudrun J. de Vries a, Laura Schiefer a, Nina Seyffert a, Hagen S. Bachmann b, Jürgen Peters a, Ulrich H. Frey a, c
a Klinik für Anästhesiologie and Intensivmedizin, University of Duisburg-Essen and Universitätsklinikum Essen, Hufelandstr. 55, D-45122 Essen, Germany 
b Institut für Pharmakologie and Toxikologie, Witten/Herdecke University, Fakultät für Gesundheit, Stockumer Straße 10, D-58453 Witten, Germany 
c Klinik für Anästhesiologie, operative Intensivmedizin, Schmerz- und Palliativmedizin, Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Germany 

Corresponding author at: Klinik für Anästhesiologie and Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, D-45122 Essen, Germany.Klinik für Anästhesiologie and Intensivmedizin, Universitätsklinikum EssenHufelandstr. 55EssenD-45122Germany

Clinical risk factors for postoperative nausea and vomiting (PONV) are usually stratified using the Apfel Score. While a genetic predisposition has recently been demonstrated with the muscarinic acetylcholine receptor (CHRM3) rs2165870 single nucleotide polymorphism (SNP), we investigated whether (1) other SNPs contribute to PONV risk and (2) a genetic risk score might summarise genetic PONV risk.


We retrospectively analysed data from a study with 472 patients undergoing elective surgery. We investigated the SNPs rs3218315 (IL2RB), rs349358 (KCNB2), rs703363 (intergenic variant), rs1800497 (DRD2), rs1799971 (OPRM1), and rs1176713 (HTR3A). A genetic risk score was established and association with PONV investigated.


Early PONV occurred in 37%. There was a significant association of the KCNB2 rs349358 SNP with nausea (P  = 0.021), retching (P  = 0.001), and PONV (P  = 0.006). The rs349358 genotype distribution was TT in 310 and TC/CC in 155 patients. The KCNB2 SNP was associated with an Odds Ratio (OR) of 1.6 for CT/CC vs. TT (95% CI 1–2.5; P  = 0.031) to develop PONV and this was independent from the Apfel Score, and the CHRM3 rs2165870 SNP. A genetic risk score based on the CHRM3 rs2165870 and the KCNB2 rs349358 SNP was created and this genetic score (OR per genetic risk score point: 1.6 (1.3–2.1), P  < 0.0001) was independent from the Apfel Score (OR per Apfel score point: 1.6 (1.3–1.9), P  < 0.0001) associated with PONV.


The KCNB2 rs349358 SNP is also an independent PONV predictor and a genetic risk score has a similar impact on PONV susceptibility compared to the Apfel Score.

The full text of this article is available in PDF format.

Keywords : PONV, rs2165870, KCNB2 , rs349358, Genetic predisposition, Apfel score

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