Short Pharmacogenomic Investigation of COMT rs4680 in Analgesic Needs of Pediatric Patients with Congenital Abnormalities: A Cross-Sectional Study

Abstract Background: Pain management is a primary concern in pediatric surgical care, particularly in patients with congenital abnormalities. Genetic differences may influence variability in analgesic response. This study aimed to explore the association between catechol-O-methyltransferase (COMT) rs4680 polymorphism and analgesic needs in pediatric patients undergoing surgery for congenital abnormalities. Materials and Methods: A total of 16 pediatric patients with congenital abnormalities undergoing surgery were selected between July 2024 and August 2024. Research samples were taken from the oral mucosa of patients after induction with an anesthetic agent. Standard intubation and therapy procedures were applied to all study subjects. Pain scores were measured using the Wong-Baker Faces Scale and Numeric Rating Scale. Results: Three genotype–phenotype combinations of the COMT rs4680 gene were identified: GG (high activity), AG (intermediate activity), and AA (low activity). The COMT rs4680 GG genotype with the high-activity phenotype was the most dominant and frequently observed in the samples. Five types of analgesic drugs were administered: fentanyl (average dose: 60.5 mcg), ibuprofen (average dose: 1500 mg), ketorolac (average dose: 45 mg), metamizole (average dose: 712.5 mg), and paracetamol (average dose: 1114.44 mg). The relationship between the COMT genotype–phenotype and postoperative pain scores was examined, but no significant correlation was found ( P value = 0.404). Conclusion: While no statistically significant association was found between COMT genotype and postoperative pain scores, observed patterns in analgesic use suggest a possible role for pharmacogenomic profiling in individualizing pain management. Further analysis is needed to understand the rationale behind the predominant use of these drugs in pediatric patients with congenital abnormalities undergoing surgery.