The Use of Methadone and Ketamine for Intraoperative Pain Management in Cardiac Surgery: A Retrospective Cohort Study
Authors' conclusion
Adding ketamine to methadone prolonged the time to first opioid consumption postoperatively but showed no benefits beyond POD 0.
Study context
- Population
- Cardiac surgery patients with CPB who received intraoperative methadone, 2018–2023, academic medical system (4 sites)
- Participants
- 6,856 patients
- Exposure
- Intraoperative methadone plus ketamine vs methadone alone
- M+Kn = 5,696
- Mn = 1,160reference
- Outcome
- Daily total oral morphine equivalents (OMEs) until POD 7 and time to first postoperative opioid administration
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Time to first postoperative opioid administration; total OMEs
M+K vs MHazard ratio (95% CI)
Time to first postoperative opioid
0.88([0.82, 0.95])
- Total oral morphine equivalents (OMEs) on postoperative day (POD) 0
- ß −2.24 (95% CI [−3.2, −1.3])
Observational data: associations, not effects.
Secondary outcomes
Daily postoperative pain scores until POD 7
- No significant differences
Exploratory: delirium and ICU LOS
- No significant differences
Original publication
The Use of Methadone and Ketamine for Intraoperative Pain Management in Cardiac Surgery: A Retrospective Cohort Study. J Cardiothorac Vasc Anesth. Published 22 November 2024. doi:10.
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