Spinal fusion surgery patients administered intraoperative methadone require less intravenous and oral postoperative opioid use for pain management, according to a study published in the journal Anesthesiology.
Methadone is a long-acting opioid used to treat patients in severe pain who need to be treated for an extended period of time. The drug is also used to curb the withdrawal symptoms of individuals addicted to heroin.
For the study, 115 spinal fusion surgery patients received either methadone during their operation or hydromorphone, an opioid often administered during surgery. Hydromorphone was given to both patient groups following surgery to manage pain.
The methadone cohort required an average of 5 milligrams of hydromorphone for pain management on day one post-surgery. The control group required a median of 10 milligrams on the first day after surgery. On day three after surgery, the methadone group received less than 1 milligram, while the control group required 3 milligrams, on average. The methadone group also reported lower pain scores than their study counterparts.
"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, MD, an anesthesiologist at NorthShore University Health System in Evanston, Ill., and the study's lead author. "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."
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