title: Methadone and morphine during anesthesia induction for cardiac surgery. Repercussion in postoperative analgesia and prevalence of nausea and vomiting.
abstract: OBJECTIVE
  Pain is an aggravating factor in postoperative morbidity and mortality especially in large size surgeries. Methods to effectively fend pain collide with elevated costs and for this reason they are not accessible in every service. The option would be the use of an opioid with long half-life, such as methadone. The objective of the present study was to compare the requirements of postoperative analgesia in patients who received methadone, morphine, or placebo during anesthetic induction, besides the prevalence of postoperative nausea and vomiting.
  
  
  METHODS
  Fifty-five patients scheduled for cardiac surgery were divided into three groups and they received during anesthetic induction 20mg of methadone, 20mg of morphine, or placebo. At the end of surgery, patients were transferred to the ICU where the following parameters were evaluated: duration of anesthesia, time until extubation, time until the need of the first analgesic, number of doses required in 24 hours, assessment of analgesia by the patient, and prevalence of nausea/vomiting.
  
  
  RESULTS
  Differences in the duration of anesthesia and time until extubation were not observed. The first dose of analgesic in patients who received methadone was administered later than in patients in the other two groups. The need of analgesics in the methadone group was lower, quality of analgesia was better, and prevalence of nausea and vomiting was also lower.
  
  
  CONCLUSIONS
  Methadone during anesthetic induction was effective for analgesia in large size surgeries. Lower incidence of nausea and vomiting was observed in the methadone group and therefore it is a low cost option available among us that should be stimulated.
authors: Anesthesiology Department, Universidade de Campinas, Campinas, SP, Brazil. audelsmann@yahoo.com.br
authors: Artur
authors: A
authors: Udelsmann
authors: Fernanda Gardini
authors: FG
authors: Maciel
authors: Derli Conceição Munhoz
authors: DC
authors: Servian
authors: Eder
authors: E
authors: Reis
authors: Teresinha Maria
authors: TM
authors: de Azevedo
authors: Marcos de Simone
authors: Mde S
authors: Melo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000758:Anesthesia; D006348:Cardiac Surgical Procedures; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D015995:Prevalence; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D008691:Methadone