title: [Postoperative analgesia with epidural methadone in patients operated for hernia of the lumbar disc].
abstract: OBJECTIVE
  To determine whether the direct application of a single dose of methadone on the dura mater at the end of surgery to repair a lumbar disk hernia provides effective analgesia over the next 24 hours.
  
  
  METHODS
  We conducted a randomized double blind study in 40 ASA I patients undergoing elective herniated disk repair under general anesthesia. The sample was divided into two groups (A and B). Group A patients received a solution of methadone in saline solution (5 mg methadone/5 ml saline) applied to the dura before the end of surgery. Group B patients (controls) received only 5 ml of saline. Pain intensity was assessed on a visual analog scale (VAS) during the postoperative period. Also recorded were the observer's impression and the amount of analgesia (ketorolac) consumed through a system providing patient controlled analgesia.
  
  
  RESULTS
  Each group contained 20 patients. Group A patients needed significantly less postoperative analgesia (64.2 +/- 14.3 mg) than group B patients (109.6 +/- 16.5 mg). The VAS scores were significantly lower in group A during the first two hours after surgery and were correlated with the observer's impression. No patients suffered serious complications during the study.
  
  
  CONCLUSIONS
  Topical administration of 5 mg of methadone on the dura mater at the end of herniated lumbar disk repair is an easy, safe and effective technique for providing postoperative analgesia.
authors.affiliation: Servicio de Anestesiologia, Hospital Universitario Virgen de la Arrixaca, Murcia.
authors.forename: J
authors.initials: J
authors.lastname: Hernández-Palazón
authors.forename: J A
authors.initials: JA
authors.lastname: Tortosa-Serrano
authors.forename: J L
authors.initials: JL
authors.lastname: Sánchez-Ortega
authors.forename: J
authors.initials: J
authors.lastname: Moya-Solera
authors.forename: J F
authors.initials: JF
authors.lastname: Martínez-Lage
authors.forename: D
authors.initials: D
authors.lastname: Pérez-Flores
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone