Pro: Methadone should be used as a part of Enhanced Recovery after Cardiac Surgery (ERACS) protocol

Methadone is a highly effective synthetic opioid (FDA approved in 1947) used primarily in opioid use disorder treatment but has been studied and used for acute perioperative pain treatment. Its duration of action is highly dependent on dose and frequency. Methadone has a short speed of onset of 6-8 minutes and redistribution half-life of approximately 6 minutes but with increasing dosage (>= 20 mg) its elimination half-life is extended to approximately 30 hours (range 8 ≥ 59 hours).1,2 Methadone's mechanism of action involves effects at several sites central in nociception including mu-opioid receptor, N-methyl-D-Aspartate receptors and inhibition of serotonin and norepinephrine reuptake in the central nervous system.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research