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