Precision Perioperative Methadone Use in Adult Cardiac Surgical Patients to Reduce Opioid Use Adverse Effects While Improving Analgesia and Outcomes
Kathirvel Subramaniam
Summary
The proposed research is an important extension of an ongoing perioperative personalized analgesia and intravenous opioid pharmacogenetic research. This research focuses on two of the most commonly used oral opioid analgesics, oxycodone, and methadone in elderly adults undergoing cardiac surgery.
Description
Cardiac surgery patients often experience significant acute postoperative pain, and untreated or undertreated pain has consequences. Each year, 900,000 painful cardiac surgeries occur in the US alone. Pain associated with cardiac surgery results from surgical incision, sternal retraction, internal mammary artery harvesting, saphenous vein removal, placement of mediastinal and chest drains, sternal wires, and release of pro-inflammatory mediators after tissue injury. One study reported that 49%, 62%, and 78% of patients reported severe pain at rest, movement, and coughing, respectively after co…
Eligibility
- Age range
- 60–110 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Elderly cardiac surgical patients over 60 years of age Exclusion Criteria: * Methadone allergy * Morbid obesity (BMI \>40kg/cm2) * Severe sleep apnea * Severe pulmonary disease requiring oxygen therapy * Preoperative mechanical circulatory support * Emergency surgery * Liver disease (liver enzymes more than two times normal) * End-stage renal disease requiring dialysis * Serum creatinine more than 2.0mg
Location
- UPMC Presbyterian HospitalPittsburgh, Pennsylvania