Cardiothoracic & vascular anesthesia
Intravenous methadone for pain management in cardiac surgery: a randomised controlled trial with plasma concentration analysis*
Authors' conclusion
Intra-operative methadone reduces postoperative analgesia requirements without increasing the incidence of opioid-related adverse events.
Study context
- Population
- Patients undergoing cardiac surgery requiring CPB80 analysed
- Participants
- 40 vs 40
- Comparison
- IV methadone 0.2 mg.kg-1 vs morphine 0.2 mg.kg-1
- Methadonen = 40
- Morphinen = 40reference
- Primary endpoint
- Postoperative morphine consumption and pain scores
- Follow-up
- 15 min and 8 h, 12 h, 24 h, 48 h and 72 h after tracheal extubation
Methodological detailsplasma concentration analysis
- Plasma concentration analysis
Primary result
As reported in the abstract
Postoperative morphine requirement · 24 h
P < 0.001
Further findings
Total postoperative morphine requirement · values as printed
P < 0.001
| Outcome | β | P value |
|---|---|---|
| Pain scores at restSE 0.49 | −2.24 | P < 0.001 |
| Pain scores on coughingSE 0.50 | −2.16 | P < 0.001 |
- Plasma methadone concentration · baseline to 24 h
- 51 · mean · SD 24.7 · ng.ml-1
- Total postoperative morphine requirement: abstract reports significantly reduced total requirement with methadone
Plasma methadone concentration · baseline to 24 h
- Decreased during CPB but remained above minimum effective analgesic concentration for ≈24 h
Safety
Opioid-related adverse effects
- No difference in incidence between the two groups
Original publication
Intravenous methadone for pain management in cardiac surgery: a randomised controlled trial with plasma concentration analysis*. Anaesthesia. Published 26 August 2025. doi:10.
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