The role of methadone in cardiac surgery for management of postoperative pain.

Autor:	Edwards JN; Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA., Whitney MA; Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA., Smith BB; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA., Fah MK; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA., Buckner Petty SA; Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, USA., Durra O; Keck School of Medicine of USC, Los Angeles, CA, USA., Sell-Dottin KA; Department of Cardiovascular Surgery, Mayo Clinic, Phoenix, AZ, USA., Portner E; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA., Wittwer ED; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA., Milam AJ; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA.; Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, USA.
Jazyk:	angličtina
Zdroj:	BJA open [BJA Open] 2024 Mar 22; Vol. 10, pp. 100270. Date of Electronic Publication: 2024 Mar 22 (Print Publication: 2024).
DOI:	10.1016/j.bjao.2024.100270
Abstrakt:	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 ( n =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 ( P <0.01). Both Groups M and M+O had lower total opioid administered compared with Group O for all days POD0-POD6 (all P <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. (© 2024 The Authors.)
Databáze:	MEDLINE
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