Methadone should not be used in cardiac surgery as part of Enhanced Recovery after Cardiac Surgery (ERACS) protocol

Methadone, originally synthesized during World War II as an analgesic substitute for morphine, is well known to the world of addiction medicine.1 Methadone's mechanism of action is multi-faceted – acting as a primary mu-receptor agonist with some kappa- and delta-receptor activity, pre-synaptic N-methyl-D-aspartate (NMDA) receptor antagonist, and inhibitor of norepinephrine and serotonin reuptake in the brain.2,3 With the introduction of Gourlay et al.’s4,5 investigations in the 1980s, integration of intravenous methadone into perioperative management has shown promise but strong clinical research remains lacking, particularly in the sphere of cardiac surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research