Nav: Home

Methadone may reduce need for opioids after surgery

April 24, 2017

CHICAGO - Patients undergoing spinal fusion surgery who are treated with methadone during the procedure require significantly less intravenous and oral opioids to manage postoperative pain, reports a new study published in the May issue of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA).

"This is a new application for an old pain medication that offers hope for reducing the development of acute pain in the first few days after surgery, as well as chronic postoperative pain and the need for opioid medications following discharge from the hospital," said Glenn S. Murphy, M.D., lead study author and physician anesthesiologist at NorthShore University Health System in Evanston, Illinois. "There is currently an opioid crisis in the United States, and intraoperative methadone offers promise as a drug that can reduce the need for these pain medications during recovery."

Methadone is a unique long-acting opioid that is typically used to relieve severe pain in people who are in need of medication around the clock for extended periods of time, and in those who cannot be treated with other medications. It is also used to prevent withdrawal symptoms in patients addicted to opiate drugs, specifically heroin.

"Appropriate pain control is essential for enhancing recovery," said Dr. Murphy. "Inadequate postoperative pain relief is associated with the development of a variety of adverse events, including cardiac and pulmonary complications, chronic postsurgical pain, decreased patient satisfaction, and increased morbidity and mortality."

Severe pain in the early postoperative period remains a common, yet underestimated and undertreated problem. Despite advances in pain management strategies, patients undergoing surgery often experience severe pain during the first three postoperative days. Acute pain after spinal fusion surgery, which includes herniated disc repair, treatment for narrowing of the spinal canal, etc., may be particularly difficult to manage. Patients undergoing complex spinal surgery often have chronic nerve pain and are dependent on oral opioid medication, which puts them at risk of addiction and other complications.

The study included 115 patients who were randomly assigned to receive either methadone or placed in a control group to receive hydromorphone, a standard opioid administered during operations, at the start of surgery or during surgical closure, respectively. Hydromorphone, which is also commonly used as a pain medication after surgery, was also given to the patients studied following surgery to treat pain. To evaluate how effective methadone was in reducing post-surgical pain, researchers measured how much hydromorphone patients took during the first three days after surgery. They also measured patients' pain scores and satisfaction with pain management during that period.

In the methadone group, patients required a median of 5 mg of hydromorphone to treat acute pain on the first day after surgery, compared to 10 mg in the control group. On the second day, patients in the methadone group required less than 1 mg of hydromorphone, compared to 3 mg in the control group. On the third day, patients in the methadone group didn't require hydromorphone, compared to less than 1 mg in the control group.

Overall, patients given methadone required significantly less intravenous and oral opioid medication after surgery, reported lower pain scores, and had improved global satisfaction with pain management, compared to patients who were given hydromorphone during surgery. No differences in opioid-related or other adverse events in either group were found, the authors note.
-end-
THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS

Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring that physician anesthesiologists evaluate and supervise the medical care of patients before, during, and after surgery to provide the highest quality and safest care that every patient deserves.For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount.

American Society of Anesthesiologists

Related Medication Articles:

Self-medication misuse is high in the Middle East
A new review indicates that there is a massive problem of self-medication misuse in the Middle East.
Another step in understanding antipsychotic medication
Antipsychotic drugs are used for the treatment of mental illnesses such as bipolar disorder and schizophrenia.
What impact do medication errors have on nursing home residents?
A new analysis points to surprisingly low rates of serious impacts from medication errors affecting nursing home residents, despite the fact that these errors remain fairly common.
Medication against schizophrenia inhibits pancreatic cancer
Scientists from the German Cancer Research Center, Heidelberg, and from McGill University, Montreal, Canada, have discovered that a receptor for the dopamine neurotransmitter promotes growth and spread of pancreatic cancer.
U-M study highlights multiple factors of ADHD medication use
Youth who take Ritalin, Adderall or other stimulant medications for ADHD over an extended period of time early in life are no more at risk for substance abuse in later adolescence than teens without ADHD, according to a University of Michigan study.
Teen suicide: ADHD medication as prevention
Black-box warnings about the dangers of attention-deficit hyperactivity disorder (ADHD) medications are confusing and could have serious consequences for the risk of youth suicide, according to researchers at the Institut universitaire en santé mentale de Montréal (CIUSSS de l'Est-de-l'Île-de-Montréal) and the University of Montreal.
Does text messaging help with medication adherence in chronic disease?
Medication adherence in chronic disease is poor. Can telephone text messaging help with adherence?
RNs more likely to identify high-risk medication discrepancies
Researchers at the University of Missouri have found that RNs are more likely than LPNs to identify high-risk medication discrepancies, suggesting RNs are better equipped to assess and identify medication errors that could pose risks to residents' safety.
After hip-replacement surgery, medication use decreases
A new study in the journal PAIN® provides information on the trajectories of prescription drug use before and after hip-replacement surgery -- total hip arthroplasty (THA), one of the most common types of joint replacement surgery.
Blood pressure medication can't undo all damage
Patients on antihypertensive medications are still at greater risk of cardiovascular disease, despite controlled numbers.

Related Medication Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Climate Crisis
There's no greater threat to humanity than climate change. What can we do to stop the worst consequences? This hour, TED speakers explore how we can save our planet and whether we can do it in time. Guests include climate activist Greta Thunberg, chemical engineer Jennifer Wilcox, research scientist Sean Davis, food innovator Bruce Friedrich, and psychologist Per Espen Stoknes.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...