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Methadone and morphine during anesthesia induction for cardiac surgery. Repercussion in postoperative analgesia and prevalence of nausea and vomiting.

Abstract：

BACKGROUND AND OBJECTIVES:Pain is an aggravating factor in postoperative morbidity and mortality especially in large size surgeries. Methods to effectively fend pain collide with elevated costs and for this reason they are not accessible in every service. The option would be the use of an opioid with long half-life, such as methadone. The objective of the present study was to compare the requirements of postoperative analgesia in patients who received methadone, morphine, or placebo during anesthetic induction, besides the prevalence of postoperative nausea and vomiting. METHODS:Fifty-five patients scheduled for cardiac surgery were divided into three groups and they received during anesthetic induction 20mg of methadone, 20mg of morphine, or placebo. At the end of surgery, patients were transferred to the ICU where the following parameters were evaluated: duration of anesthesia, time until extubation, time until the need of the first analgesic, number of doses required in 24 hours, assessment of analgesia by the patient, and prevalence of nausea/vomiting. RESULTS:Differences in the duration of anesthesia and time until extubation were not observed. The first dose of analgesic in patients who received methadone was administered later than in patients in the other two groups. The need of analgesics in the methadone group was lower, quality of analgesia was better, and prevalence of nausea and vomiting was also lower. CONCLUSIONS:Methadone during anesthetic induction was effective for analgesia in large size surgeries. Lower incidence of nausea and vomiting was observed in the methadone group and therefore it is a low cost option available among us that should be stimulated.

journal_name

Rev Bras Anestesiol

journal_title

Revista brasileira de anestesiologia

authors

Udelsmann A,Maciel FG,Servian DC,Reis E,de Azevedo TM,Melo Mde S

doi

10.1016/S0034-7094(11)70078-2

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

695-701

issue

eissn

0034-7094

issn

1806-907X

pii

S0034-7094(11)70078-2

journal_volume

pub_type

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Methadone and morphine during anesthesia induction for cardiac surgery. Repercussion in postoperative analgesia and prevalence of nausea and vomiting.