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Methadone is a long-acting opioid that has been reported to reduce postoperative pain scores and analgesic needs, as well as to reduce the development of chronic pain after surgery.
Recently, researchers from the University of Chicago's Pritzker School of Medicine conducted a second analysis of two previous trials to follow up patients receiving single doses of methadone or traditional opioids during complex spinal or cardiac surgery, the results of which were published online online in Anestheology.
analyzed the long-term results of patients with spinal surgery who received 0.2 mg/kg methadone at the beginning of the operation or 2 mg of hydro morphine at the end of the operation, and patients with heart surgery who received 0.3 mg/kg methadone or 12 mg/kg fentanyl at the end of the operation.
subjects' weekly pain frequency (main results) and pain intensity were assessed in questionnaires 1, 3, 6 and 12 months after surgery.
results showed that patients who were randomly treated with methadone for spinal surgery three months after surgery had a lower frequency of chronic pain per week (a median score of 0 to 4 points was 0 (less than once a week), while the hydro morphine group had a 3-point (daily) and P-0.004).
patients who underwent methadone treatment for heart surgery reported less frequent pain after surgery at 1 month (median score 0) than patients who received fentanyl (median score of 2 (twice a week), P s 0.004).
In summary, the results showed that a single dose of methadone had better analgesic effects in the first 3 months after spinal surgery (not at 6 and 12 months) and in the first month after heart surgery, i.e. when pain intensity and frequency were greatest.