Artículos de revistas
Methadone And Morphine During Anesthesia Induction For Cardiac Surgery. Repercussion In Postoperative Analgesia And Prevalence Of Nausea And Vomiting [metadona E Morfina Na Indução Da Anestesia Em Cirurgia Cardíaca. Repercussão Na Analgesia Pós-operatória E Prevalência De Náuseas E Vômitos]
Registro en:
Revista Brasileira De Anestesiologia. , v. 61, n. 6, p. 695 - 701, 2011.
347094
10.1016/S0034-7094(11)70078-2
2-s2.0-84855981667
Autor
Udelsmann A.
Maciel F.G.
Servian D.C.M.
Reis E.
de Azevedo T.M.
Melo M.D.S.
Institución
Resumen
Background and objectives: Pain is an aggravating factor in postoperative morbidity and mortality especially in large size surgeries. Methods to effectively fend pain collide with elevated costs and for this reason they are not accessible in every service. The option would be the use of an opioid with long half-life, such as methadone. The objective of the present study was to compare the requirements of postoperative analgesia in patients who received methadone, morphine, or placebo during anesthetic induction, besides the prevalence of postoperative nausea and vomiting. Methods: Fifty-five patients scheduled for cardiac surgery were divided into three groups and they received during anesthetic induction 20. mg of methadone, 20. mg of morphine, or placebo. At the end of surgery, patients were transferred to the ICU where the following parameters were evaluated: duration of anesthesia, time until extubation, time until the need of the first analgesic, number of doses required in 24 hours, assessment of analgesia by the patient, and prevalence of nausea/vomiting. Results: Differences in the duration of anesthesia and time until extubation were not observed. The first dose of analgesic in patients who received methadone was administered later than in patients in the other two groups. The need of analgesics in the methadone group was lower, quality of analgesia was better, and prevalence of nausea and vomiting was also lower. Conclusions: Methadone during anesthetic induction was effective for analgesia in large size surgeries. Lower incidence of nausea and vomiting was observed in the methadone group and therefore it is a low cost option available among us that should be stimulated. © 2011 Elsevier Editora Ltda. 61 6 695 701 Toombs, J.D., Kral, L.A., Methadone treatment for pain states (2005) Am Fam Physician, 71, pp. 1353-1358 Fishman, S.M., Wilsey, B., Mahajan, G., Molina, P., Methadone reincarnated: nouvel clinical applications with related concerns (2002) Pain Med, 3, pp. 339-348 Bruera, E., Sweeney, C., Methadone use in cancer patients with pain: a review (2002) J Palliat Med, 5, pp. 127-138 Gourlay, G.K., Wilson, P.R., Glynn, C.J., Methadone produces prolonged postoperative analgesia (1982) Br Med J, 284, pp. 630-631 Berde, C.B., Beyer, J.E., Bournaki, M.C., Levin, C.R., Sethna, N.F., Comparison of morphine and methadone for prevention of postoperative pain in 3- to 7- year old children (1991) J Pediatr, 119, pp. 136-141 Simoni, R.F., Cangiani, L.M., Pereira, A.M.S.A., Abreu, M.P., Cangiani, L.H., Zemi, G., Eficácia do emprego da metadona ou da clonidina no intraoperatório para controle da dor pós-operatória imediata após uso de remifentanil (2009) Rev Bras Anestesiol, 59, pp. 421-430 Broadman, L., Blocks and other techniques pediatric surgeons can emply to reduce postoperative pain in pediatric patients (1999) Semin Pediatr Surgery, 8, pp. 30-33 Shaiova, L., Berger, A., Blinderman, C.D., Consensus guideline on parenteral methadone use in pain and palliative care (2008) Palliat Support Care, 6, pp. 165-176 Gourlay, G.K., Willis, R.J., Lamberty, J., A double-blind comparison of the efficacy of methadone and morphine in postoperative pain control (1986) Anesthesiology, 64, pp. 322-327 Richlin, D.M., Reuben, S.S., Postoperative pain control with methadone following lower abdominal surgery (1991) J Clin Anesth, 3, pp. 112-116 Gottschalk, A., Durieux, M.E., Nemergut, E.C., Intraoperative methadone improves postoperative pain control in patients undergoing complex spinal surgery (2011) Anesth Analg, 112, pp. 218-223 Jordan, B., Devi, L.A., Molecular mechanisms of opioid receptor signal transduction (1998) Br J Anaesth, 81, pp. 12-19 Peng, P.W.H., Tumber, O.S., Gourlay, D., Review article: Perioperative pain management of patients on methadone therapy (2005) Can J Anesth, 52, pp. 513-523 Stringer, J., Welsh, C., Tomasello, A., Metahdone-associated Q-T interval prolongation and torsades de pointes (2009) Am J Health-Syst Pharm, 66, pp. 825-833 Hum, A., Faisinger, R.L., Bielech, M., Subcutaneous methadone - an issue revisited (2007) J Pain Symptom Manage, 34, pp. 573-575 Davis, M.P., Walsh, D., Methadone for relief of cancer pain: a review of pharmacokinetics, pharmacodynamics, drug interactions and protocols of administration (2001) Support Care Cancer, 9, pp. 73-83