Evaluating the efficacy of perioperative methadone in cardiac surgery

Author

Brock ThorntonFollow

Date of Award

Spring 5-2024

Document Type

DNP Project

Project Team Faculty Member

Nicholas Collier

Project Team Faculty Member

Michelle Ertel

Project Team Faculty Member

Mary Zerlan

Keywords

Cardiac Surgery, Methadone, Opioids, Analgesia, Chronic Pain, Enhanced Recovery After Surgery (ERAS)

Abstract

Cardiac surgery includes a myriad of highly invasive and complex procedures that can lead to the development of chronic pain and delayed patient recovery (Murphy et al., 2015). Despite frequent administration of opioid medications, cardiac surgery is associated with moderate to severe pain in up to 75% of patients (Bolton et al., 2019; Choinière et al., 2014; Wang, Song, & Nault, 2021). Methadone, a long-acting synthetic opioid medication, improves analgesia and decreases the risk of chronic pain syndromes among multiple surgical populations. Literature within the last five years suggests a single dose of intravenous methadone in cardiac surgery (0.1-0.3 mg/kg or 20mg maximum) prior to surgical incision significantly decreases total opioid consumption and improves postoperative pain scores. This project aimed to review the literature surrounding perioperative methadone in cardiac surgery and bridge knowledge gaps among anesthesia providers on its pharmacology, contraindications, and clinical administration, by which future methadone protocols may be developed. A pre-test, PowerPoint presentation, and post-test survey were administered to anesthesia providers at a large tertiary care center in central Illinois. Evidence implementation significantly improved the providers’ knowledge on the topic, and buy-in was achieved for the development of future methadone protocols.

Recommended Citation

Thornton, Brock, "Evaluating the efficacy of perioperative methadone in cardiac surgery" (2024). Doctor of Nursing Practice Projects. 316.
https://spark.siue.edu/dnpprojects/316

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