Methadone Use in Postoperative Pain Management: A Systematic Review

Postoperative pain is a commonly discussed topic in patients undergoing anesthesia for cardiac and thoracic surgery. Uncontrolled or poorly treated postoperative pain has been studied to cause poor outcomes in patients. Prolonged pain experienced by the patient can increase the risk of infection, respiratory compromise, development of chronic pain, and death. Current studies look at multiple modalities of treatment of postoperative pain, however, a long acting drug that is often under looked and underused is methadone. Methadone has a prolonged effect that can provide analgesia for an extended period of time. ). The purpose of this paper is to conduct a systematic review to determine if intraoperative methadone administration will affect postoperative pain after cardiothoracic and thoracic surgery as evidenced by pain score levels and documented postoperative opioid use. This systematic review was created using guidelines put forth by both PRISMA and CONSORT. A literature review was performed, and data was gathered from each study. A cross study analysis was performed using data collection tables designed by the author of this systematic review. Methadone was found to have a prolonged effect, but evidence was inconclusive due to many limitations by each of the studies. It is suggested that methadone should be further evaluated in additional systematic reviews.