The Role of Methadone in Cardiac Surgery for Management of Postoperative Pain

Overview

Journal BJA Open

Specialty Anesthesiology

Date 2024 Apr 1

PMID 38560623

Authors

Jordan N Edwards

Madeline A Whitney

Bradford B Smith

Megan K Fah

Skye A Buckner Petty

Omar Durra

Kristen A Sell-Dottin

Erica Portner

Erica D Wittwer

Adam J Milam

Affiliations

Soon will be listed here.

Abstract

Background: This retrospective study evaluated the efficacy and safety of intraoperative methadone compared with short-acting opioids.

Methods: Patients undergoing cardiac surgery with cardiopulmonary bypass (=11 967) from 2018 to 2023 from a single health system were categorised into groups based on intraoperative opioid administration: no methadone (Group O), methadone plus other opioids (Group M+O), and methadone only (Group M).

Results: Patients in Groups M and M+O had lower mean pain scores until postoperative day (POD) 7 compared with Group O after adjusting for covariates (<0.01). Both Groups M and M+O had lower total opioid administered compared with Group O for all days POD0-POD6 (all <0.001). The median number of hours until initial postoperative opioid after surgery was 2.55 (inter-quartile range [IQR]=1.07-5.12), 6.82 (IQR=3.52-12.98), and 7.0 (IQR=3.82-12.95) for Group O, Group M+O, and Group M, respectively. The incidence of postoperative complications did not differ between groups.

Conclusions: Intraoperative administration of methadone was associated with better pain control without significant side-effects after cardiac surgery.

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