Each year more than 300 million surgeries are performed worldwide. Although much progress has been seen in the treatment of pain using multimodal treatment strategies and improving organisational structures by implementing acute pain services, pain after surgery is still an unresolved problem. There are large interindividual differences in postsurgical pain, pain-related functional impairment, and analgesic requirements. Severe acute pain can transform into chronic postsurgical pain, resulting in long-term disability, suffering, and decreased quality of life.Research focusFactors have been identified which contribute to the variability of pain outcomes, the development of chronic postsurgical pain, and differences in analgesic requirements. The Clinical and Molecular Pain Research Group is currently investigating a variety of pain-related topics:
Metabolism of drugs
Genetic diversity influences the efficacy and safety of various classes of drugs, including analgesics. In recent years, promising candidate genes have been identified – for example, drug-metabolizing enzymes having a major impact on postoperative analgesia and success of treatment of opioid-mediated side effects of postoperative nausea and vomiting. This includes CYP2D6-dependent metabolism of drugs like tramadol, codeine, and oxycodone, as well as tricyclic antidepressants used in chronic pain management (e.g., amitriptyline) and antiemetics.
Pain sensitivity and neuropathic pain
Genetic polymorphisms have been linked to varying pain sensitivity, development of specific chronic pain diseases, the risk of chronic postsurgical pain, and specific pain characteristics, such as neuropathic pain. Study results are equivocal so far; thus sufficiently powered trials would be of considerable clinical interest.
Nociceptin and its receptor
Results from clinical and experimental studies indicate a peripheral immune-regulatory role of nociceptin during inflammation and nociceptive processing. Research focuses on modulation of nociception and its receptor in human peripheral blood leukocytes.
As part of an international pain registry, we collect standardised patient data for the perioperative period, including validated patient questionnaires on pain-related short-term and long-term outcomes. This registry enables internal benchmarking for quality control of postoperative pain management, and provides a well-phenotyped cohort which can be analysed in our department for clinical and genetic
Ying-Yu Hedinger, Dr. Sc., Head of Lab
Derborah Hofer, Dr. med
Harnik Michael, Dr. med
Frank Stüber, Prof. Dr. med.