CYP2D6 Testing and Postoperative Opioids
Investigators evaluate whether genotype-guided prescribing improves postoperative pain management.
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By
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Kathryn Wighton
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March 9, 2026
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Clinical Scorecard: CYP2D6 Testing and Postoperative Opioids
At a Glance
| Category | Detail |
|---|
| Condition | Postoperative Pain Management |
| Key Mechanisms | CYP2D6 genotype-guided opioid prescribing |
| Target Population | Patients undergoing surgery with expected postoperative pain lasting 7 to 10 days |
| Care Setting | Multicenter hospitals across the US |
Key Highlights
- Genotype-guided prescribing increased concordance between opioid selection and metabolic phenotype.
- Postoperative pain intensity and opioid use were similar between genotype-guided and usual care groups.
- Hydromorphone prescribing was more common in the genotype-guided group compared to the control group.
Guideline-Based Recommendations
Diagnosis
- Perform CYP2D6 genotyping prior to surgery in patients with actionable phenotypes.
Management
- Avoid tramadol, hydrocodone, and codeine in poor or intermediate metabolizers.
Monitoring & Follow-up
- Assess pain outcomes and opioid use postoperatively.
Risks
- Potential for variability in pain outcomes and adherence to genotype-based recommendations.
Patient & Prescribing Data
1,602 patients scheduled for surgery, excluding those with chronic opioid use.
Multimodal analgesia strategies were commonly used, including nerve blocks and nonopioid medications.
Clinical Best Practices
- Implement multimodal pain management strategies to reduce opioid use.
- Monitor for adherence to genotype-guided prescribing recommendations.
References
