Consideration of Methadone as an Analgesic Option for Short-stay Surgery

Advances in anesthetic techniques and drugs, along with laparoscopic and other minimally invasive surgical approaches, have led to a growing proportion of procedures being undertaken on an ambulatory or short-stay basis. This is highly cost-effective and a benefit to society.^1,2  Perioperative and postdischarge pain relief are important components of success, but despite many advances in anesthetic and perioperative care, postsurgical pain remains a major unmet need. Moreover, reducing postoperative opioid prescribing after surgical discharge has been an area of focus in recent years.³ 

Methadone is a synthetic long-acting opioid agonist with a long and variable elimination half-life of 24 to 36 h, and a peak effect site concentration achieved in 8 min after intravenous injection.⁴  Methadone is also a weak N-methyl-d-aspartate receptor antagonist,⁵  offering potential for reducing opioid-induced hyperalgesia and chronic postsurgical pain.^6,7  Its titratability and prolonged action...