Abstract

Spine surgery, notorious for causing severe postoperative pain, is often accompanied by elevated rates of opioid usage, necessitating exploration of opioid-sparing approaches to mitigate associated complications. Among these approaches, methadone, a potent mu-receptor agonist with a prolonged half-life of 24-36 hours, has emerged as a promising candidate for reducing postoperative opioid consumption when administered intraoperatively. When given in doses ≥ 20 mg, methadone's analgesic effect duration mimics its half-life. This case study involves a 52-year-old ASA III female with a history of chronic pain syndrome presenting for posterior fusion of T12-L4 and received methadone 20 mg PO just prior to surgery. The only additional opioid administered intraoperatively was fentanyl 100 mcg. The time to first dose of opioid after arrival to PACU was 8 hours. In total, 60 mg of hydrocodone was the only opioid administered in the first 24-hour postoperative period. No intravenous opioids were given throughout the patient's 5-day postoperative course. The literature surrounding methadone's utilization in spine surgery is comprehensively reviewed in this case study. In adults undergoing spine surgery, does single-dose intraoperative methadone reduce postoperative opioid consumption compared to other opioids throughout the first 24-hour postoperative period?

Nathaniel Cline

Author Details

Nathaniel Cline, BSN, RN

Sigma Membership

Unknown

Lead Author Affiliation

Samford University, Birmingham, Alabama, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Literature Review

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Methadone, Opioid-Sparing, Multimodal Analgesia, Postoperative Pain Management

Advisor

Sanford, David

Degree

DNP

Degree Grantor

Samford University

Degree Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2024-01-29

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