Home E-Weekly May 2, 2017

Methadone Reduces Need for Post-op Opioids

Published: May 1, 2017

LIGHT TOUCH The findings could help lessen the nationwide grip of the opioid crisis.

Methadone, the medication that's used to prevent withdrawal symptoms in opioid addicts, might be the key to reducing the amount of prescription painkillers patients need to manage post-op pain, according to a study published in the journal Anesthesiology.

Researchers recently assessed the outcomes of 115 spinal fusion patients who received intraoperative doses of methadone or hydromorphone, the pain-controlling opioid that's typically given during the procedures. All patients received prescriptions for hydromorphone, which is also used post-operatively to treat breakthrough pain. The researchers assessed how well methadone limited post-op discomfort by determining the amount of hydromorphone patients took during the initial 3 post-op days, as well as their reported pain scores and satisfaction with the pain control regimen.

According to the findings, patients who received intraoperative doses of methadone during surgery needed less post-op hydromorphone than patients who did not receive methadone: 5mg vs. 10 mg on day 1; less than 1 mg vs. 3 mg on day 2; and no hydromorphone vs. less than 1 mg on day 3. The patients who received methadone also reported lower pain scores and expressed greater satisfaction in how well their pain was managed.

The consequences of uncontrolled post-op pain are well known: cardiac and pulmonary complications, chronic postsurgical pain, decreased patient satisfaction, and increased morbidity and mortality. The use of opioids to manage acute pain immediately after surgery comes with its own concerns, notably the increased risk of dependence and addition to the powerful painkillers.

"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," says Glenn Murphy, MD, lead study author and anesthesiologist at NorthShore University Health System in Evanston, Ill. "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."

Daniel Cook

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