The Opioid Crisis and Methadone Use in Outpatient Surgery

The podcast episode discusses the opioid crisis and the use of methadone in outpatient surgery. It emphasizes that the opioid crisis was not caused by anesthesiologists using opioids for surgery but by the overprescription of oral opioids for non-surgical patients. The episode challenges the idea of completely withholding opioids from patients during surgery and advocates for a balanced and multimodal approach to pain management. It highlights that pain after outpatient surgery can be just as severe as after inpatient surgery and the importance of adequately controlling it to prevent post-surgical complications and persistent pain. Additionally, it explores the unique pharmacokinetics of methadone, including its rapid onset and long duration of action, which make it a potential option for managing acute surgical pain. The podcast concludes by suggesting that further research, particularly larger scale phase three trials, is needed to fully evaluate the benefits and potential risks of methadone in different patient populations and surgical settings.