Genomics01

Genomics in the OR. Finally.

CYP450 gene variants directly determine how patients metabolize opioids and volatile anesthetics, yet pharmacogenomics is almost never reflected in routine pre-op planning.

Why it matters02

CYP450 metabolism variants can materially change how a patient responds to standard perioperative pain regimens, sedatives, and rescue medications.

Without genomic context, two patients with identical procedure plans may absorb or clear the same drug at dramatically different rates.

Checksalus uses available genomic panels to modulate risk scoring and recommendation logic before the first incision, not after an adverse reaction.

Poor MetabolizerIntermediateNormalRapidUltra-Rapid

Higher-risk metabolism states compress dosing margin and change expected opioid response.

Clinical implication

Poor CYP2D6 metabolizer + standard codeine dose = opioid toxicity risk

Genes03

Codeine, oxycodone, and tramadol metabolism. Often the most clinically relevant variant family for perioperative pain management.

Fentanyl, midazolam, and alfentanil exposure. Variable expression can materially affect sedation depth and recovery timing.

Pain sensitivity and opioid requirements. Variants like Val158Met can influence perceived pain burden and medication needs.

Data Flow04
01

Lab Result

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Panel Import

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Variant Annotation

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Score Modification

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Drug Recommendation

What if the patient has not had genomic testing?

The score falls back to population priors and clearly flags that genomic enrichment is unavailable, so clinicians can separate absence of evidence from low risk.

Actions05

Clinical actions tied to the genomic signal, not just the lab value.

  • Flag opioid metabolism outliers before default post-op pain pathways are selected.
  • Adjust anesthesia planning language when sedation depth or emergence may vary from expected norms.
  • Surface a concise explanation so the care team sees why the recommendation changed, not just that it changed.

Genomics lab integrations

GenomicLifeTempus

Panel results accepted in VCF and HL7 FHIR Genomics format.

Adoption

Start with imported reports. Expand to native lab connections later.

Programs can begin with PDF-backed or historical panel results, then graduate into live partner integrations once perioperative demand is validated.

Zero genomic integration exists in any other surgical AI tool.

See the full platform