title: Plasma concentrations of methadone during postoperative patient-controlled extradural analgesia.
abstract: Plasma concentrations of methadone were measured by gas chromatography in 16 patients receiving extradural methadone by continuous infusion for relief of postoperative pain. Venous blood samples were taken after a loading dose of extradural methadone 2 mg and during infusion of 0.46 mg h-1 plus patient-controlled increments of 0.2-1 mg. Mean (SD) plasma concentration of methadone was 9.8 (2.1) ng ml-1 at 15 min; this did not change significantly during the first 2 h, after which it increased gradually to 32.2 (4.6) ng ml-1 (P less than 0.001) at the end of 24 h. The mean quantity of extradural methadone required to produce effective analgesia was 10.3 (1.8) mg during the first 12 h after operation and 6 (1.0) mg for the subsequent 12 h. The mean amount of methadone for effective analgesia on the second day was 7.6 (1.1) mg. No adverse effects were detected during the 2-3 days of methadone therapy. Plasma concentration of methadone increased significantly during patient-controlled infusion of extradural methadone in the first 24 h after operation, suggesting rapid vascular uptake. Systemic activity of the drug contributes to the analgesic effect of extradural methadone.
authors.affiliation: Department of Anaesthesiology, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Shir
authors.forename: D
authors.initials: D
authors.lastname: Eimerl
authors.forename: F
authors.initials: F
authors.lastname: Magora
authors.forename: D
authors.initials: D
authors.lastname: Damm
authors.forename: J
authors.initials: J
authors.lastname: Schulte-Monting
authors.forename: J
authors.initials: J
authors.lastname: Chrubasik
mesh_terms: D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D002849:Chromatography, Gas; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use; D008875:Middle Aged; D010149:Postoperative Pain / Q000097:blood / Q000188:drug therapy*
chemical_list: D008691:Methadone