Freire Juliana M, Dos Santos Silas Augusto G, Confessor de Sousa Raphael K, Nascimento Matheus S, Medeiros Heitor Js, Martins Rand R, De Medeiros Silva Pedro H, de Godoy Eudes P, Da Silva Wallace
Department of Anesthesiology, Hospital Universitário Onofre Lopes, Natal, BRA.
Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, USA.
Cureus. 2025 Jan 8;17(1):e77127. doi: 10.7759/cureus.77127. eCollection 2025 Jan.
This study aimed to assess postoperative pain in patients who received a single dose of methadone during the anesthetic-surgical procedure, as well as to evaluate adverse effects. Methods: A randomized, double-blind, clinical trial with patients undergoing video laparoscopic bariatric surgery. Immediately after anesthesia induction, the methadone group (MG) received 10 mg of methadone diluted in 100 ml of 0.9% saline, and the Control group (CG) received only 100 ml of 0.9% saline (without methadone in this group). The assessment of pain was made using the visual analog scale (VAS), 10 minutes after extubation in the post-anesthesia care unit (PACU) and six, 12, and 24 hours after surgery. The presence of nausea and vomiting, respiratory depression, and the need for postoperative rescue opioids were analyzed. Results: A total of 16 patients were allocated in the MG and 18 in the CG. The MG showed a lower average of pain scores on the VAS over 24 hours, with a significant difference in the first 10 minutes postoperatively. Furthermore, it showed a greater decrease in VAS pain scores over 24 hours (β = -1.984; p<0.001) compared to the CG. In the postoperative period, no significant difference was found between the groups regarding rescue morphine use within the first 24 hours (p=0,469), except during the PACU period, the rescue morphine use was higher in the CG (p=0,005). There was no significant difference regarding the presence of nausea and vomiting (p=0.372). Conclusion: Our findings suggested that intravenous methadone single dose in laparoscopic bariatric surgery was safe, achieving better postoperative pain outcomes.
本研究旨在评估在麻醉手术过程中接受单剂量美沙酮治疗的患者的术后疼痛情况，并评估其不良反应。方法：对接受视频腹腔镜减肥手术的患者进行一项随机、双盲临床试验。麻醉诱导后，美沙酮组（MG）接受10毫克美沙酮用100毫升0.9%生理盐水稀释后的溶液，对照组（CG）仅接受100毫升0.9%生理盐水（该组不含美沙酮）。在麻醉后护理单元（PACU）拔管后10分钟以及术后6、12和24小时，使用视觉模拟量表（VAS）评估疼痛。分析恶心呕吐、呼吸抑制的发生情况以及术后使用急救阿片类药物的必要性。结果：MG组共分配了16例患者，CG组共分配了18例患者。MG组在24小时内的VAS疼痛评分平均值较低，术后前10分钟有显著差异。此外，与CG组相比，MG组在24小时内VAS疼痛评分的下降幅度更大（β = -1.984；p<0.001）。在术后期间，两组在术后24小时内使用急救吗啡方面无显著差异（p = 0.469），但在PACU期间，CG组的急救吗啡使用率较高（p = 0.005）。在恶心呕吐的发生方面无显著差异（p = 0.372）。结论：我们的研究结果表明，腹腔镜减肥手术中静脉注射单剂量美沙酮是安全的，术后疼痛效果更好。
