Comprehensive Perioperative Management Considerations in Patients Taking Methadone

Curr Pain Headache Rep. 2019 Jun 17;23(7):49. doi: 10.1007/s11916-019-0783-z.

Abstract

Purpose of review: Well-informed staff can help decrease risks and common misconceptions regarding opioid-tolerant patients, especially those taking methadone.

Recent findings: In 2015, opioid pain relievers were the second most used drug at 3.8 million. Overdose death was three times greater in 2015 than in 2000. Medication-assisted treatment was sought by more than 2 million individuals with substance use disorder, one of which is methadone. Chronic pain affects millions of adults in the USA. Opioid therapy is widely used among these adults. Related to the risk of abuse and dependence, guidelines suggest that opioid therapy may not be considered first-line treatment. A multidisciplinary approach, including thorough preoperative evaluation, the utilization of multimodal pain management strategies, and opioid-sparing techniques in both the intraoperative and postoperative periods will allow for the best possible outcome.

Keywords: Methadone; Multimodal analgesia; Opioids; Pain; Pain management; Perioperative.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Buprenorphine / therapeutic use
  • Chronic Pain / drug therapy*
  • Humans
  • Methadone / adverse effects
  • Methadone / therapeutic use*
  • Opioid-Related Disorders / drug therapy*
  • Pain Management / methods

Substances

  • Analgesics, Opioid
  • Buprenorphine
  • Methadone