Date of Award

Spring 5-2024

Document Type

DNP Project

Project Team Faculty Member

Mary Zerlan

Keywords

alternative to intraoperative opioids, chronic pain management, methadone, NMDA antagonist, postoperative pain

Abstract

This study investigates the efficacy of intravenous methadone as an alternative to traditional opioids for postoperative pain management following major surgeries. A comprehensive literature review, including randomized controlled trials, meta-analysis, and retrospective studies, was conducted. The findings highlight methadone’s effectiveness in reducing postoperative pain, with advantages over conventional opioids in various surgical scenarios. However, its use necessitates caution due to several potential risks. Methadone’s dual role as an opioid agonist and NMDA antagonist makes it effective in preventing the transition from acute to chronic postoperative pain, positioning it as a valuable tool in chronic pain management. Its cost-effectiveness further enhances its sustainability for long-term pain management strategies. The study concludes with the development of a methadone protocol for a major hospital in central Illinois, aimed at improving the anesthesia staff’s understanding and application of methadone. The project’s findings were presented to hospital staff, with evaluations indicating significant knowledge enhancement and a willingness to incorporate methadone into anesthetic plans. This research underscores the potential of methadone in transforming postoperative pain management, emphasizing the need for ongoing research to refine dosing guidelines and broaden its application across diverse surgical procedures.

Comments

We'd like to thank Dr. Zerlan for her guidance, and Dr. Collier for allowing us to implement this project at HSHS St. John's Hospital.

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