Oral Methadone for Cardiac Surgery

(OMICS Trial)

This trial explores different methods of using methadone to manage pain after heart surgery. Researchers aim to determine whether taking methadone orally before surgery is more effective than receiving it through an IV during surgery for reducing postoperative pain. Individuals scheduled for elective heart surgery, who do not have chronic pain or other specific health issues, might be suitable candidates for this study. As a Phase 4 trial, this research seeks to understand how the already FDA-approved and effective methadone can further benefit patients in managing post-surgery pain.

The trial information does not specify if you need to stop taking your current medications. However, if you have chronic pain requiring opioid medications or an opioid use disorder, you may not be eligible to participate.

Research has shown that methadone is generally safe and effective for managing pain during and after heart surgery. Studies found that using methadone during surgery helps control pain without causing major side effects, indicating its safety for this use. Methadone's approval for pain relief in other conditions further supports its safety. Overall, methadone appears to be a safe choice for reducing pain after heart surgery.¹²³⁴⁵

Unlike the standard pain management options for cardiac surgery, which typically involve intravenous opioids like morphine or fentanyl, this study explores methadone delivered both orally and intravenously. Researchers are excited about oral methadone because it offers a unique delivery method that could simplify pain management by potentially reducing the need for complex IV setups before surgery. Additionally, methadone is known for its long-acting pain relief and ability to stabilize opioid receptors, which might provide more sustained control of postoperative pain compared to short-acting alternatives. This could lead to improved patient comfort and potentially faster recovery times.

Research has shown that methadone can help manage pain after heart surgery. In this trial, participants will receive either oral methadone immediately before transport for surgery or intravenous methadone during surgery. Oral methadone before surgery has shown mixed results; some studies find it doesn't significantly lower pain scores but does reduce the need for other pain medications. In contrast, intravenous methadone during surgery has been linked to better pain control and fewer side effects. Both methods help reduce pain 24 hours after surgery and decrease the need for other opioids upon hospital discharge. Overall, methadone is generally effective and safe for managing pain during recovery from heart surgery.¹²³⁴⁶