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The safe and effective analgesia during and after surgery is an important clinical, social and economic problem. The goal of good analgesia is an individual balancing that patient's pain is reduced to a low level, and side effects are minimized. Data from the literature suggest genetic differences between patients in their ability to metabolize a particular drug. The effect of the drug is determined by interreaction of several genetic polymerphisms that affect the pharmacokinetics and pharmacodynamics of the drug, including differences in potency of binding to receptors and activity of drug enzymes and transportters. There is evidence suggesting that mutations of the mu-opioid receptor gene affects interindividual differences in opioid sensitivity. This review of the literature aims to analyze the current knowledge on the impact of genetic polymorphisms of CYP3A4, ABCB1 C3435, ABCB1 2677 and OPRM1 A118G gene on analgesic effect and side effects of opioids in the treatment of postoperative pain.