Intraoperative Methadone for Postoperative Pain Control After Thoracic Surgery
Status:
Recruiting
Trial end date:
2021-12-12
Target enrollment:
Participant gender:
Summary
Pain following surgery continues to be an important adverse outcome that may impact
postoperative recovery. Opioids like fentanyl and hydromorphone are the primary medications
used to provide analgesia, but paradoxically, may actually worsen pain when administered in
the operating room. Methadone is a unique opioid which has N-methyl-D-aspartate (NMDA)
receptor blocking properties, which may prevent the development of opioid-induced tolerance
and hyperalgesia (increased sensitivity to pain induced by a drug). Studies have demonstrated
that methadone reduces the need for analgesic medications and decreases pain after surgery.
Furthermore, the addition of methadone to a standard anesthetic has been demonstrated to
increase patient satisfaction with pain management and reduce the need for opioid analgesic
medications during the first month after surgery. Some investigators have described methadone
as a "opioid-sparing opioid" and recommended its use as part of a multimodal pain management
strategy.
There is a growing interest in reducing the use of traditional opioids in the operating room.
The aim of this clinical trial is to compare pain scores and analgesic requirements in two
groups of patients; one group will be randomized to receive a small dose of methadone at the
start of surgery. The other group will be randomized to receive an equal volume of saline
(salt water-control group) at the start of surgery. We hypothesize that patients randomized
to be administered methadone at the start of surgery will have less postoperative pain and
may require lower doses of pain medications than those given saline-control..