{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:56:30Z","timestamp":1787014590876,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,7,26]],"date-time":"2012-07-26T00:00:00Z","timestamp":1343260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2012,11]]},"abstract":"\n Background<\/jats:title>\n \n A synergy between ketamine and methadone (\n ME<\/jats:styled-content>\n ) to produce antinociception has been demonstrated in experimental neuropathy. We wanted to compare post\u2010operative opioid requirements in patients undergoing multilevel lumbar arthrodesis after the administration combined\n ME<\/jats:styled-content>\n \u2013ketamine (\n MK<\/jats:styled-content>\n ) or\n ME<\/jats:styled-content>\n alone.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was a randomised double\u2010blind study. During sevoflurane\u2013remifentanil anaesthesia, 11 patients in each group received the following: ketamine bolus (0.5\u2009mg\/kg) after tracheal intubation, followed by an infusion of 2.5\u2009\u03bcg\/kg\/min in the\n MK<\/jats:styled-content>\n or saline bolus plus infusion in the\n ME<\/jats:styled-content>\n group. Post\u2010operative analgesia \u2013 during 48\u2009h \u2013 was provided by patient\u2010controlled analgesia (\n PCA<\/jats:styled-content>\n ), delivering bolus containing the following:\n ME<\/jats:styled-content>\n 0.25\u2009mg plus ketamine 0.5\u2009mg in the\n MK<\/jats:styled-content>\n group or\n ME<\/jats:styled-content>\n 0.5\u2009mg in the\n ME<\/jats:styled-content>\n group. Lockout was 10\u2009min, maximum of 3 boluses\/h in both groups. Before closing the wound, all the patients received intravenous (i.v.)\n ME<\/jats:styled-content>\n 0.1\u2009mg\/kg, dexketoprophen and paracetamol. Pain intensity was evaluated by a numerical rating scale (\n NRS<\/jats:styled-content>\n ), on arrival at recovery room (\n RR<\/jats:styled-content>\n ) and 24 and 48\u2009h after surgery. In the\n RR<\/jats:styled-content>\n , i.v.\n ME<\/jats:styled-content>\n was administered until\n NRS<\/jats:styled-content>\n was 3 when\n PCA<\/jats:styled-content>\n was started. Dexketoprophen and paracetamol were administered 48\u2009h.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Remifentanil requirements were higher in the\n MK<\/jats:styled-content>\n group (\n \n P<\/jats:styled-content>\n <\/jats:italic>\n \u2009=\u20090.004). Patients in the\n MK<\/jats:styled-content>\n group received 70% less\n ME<\/jats:styled-content>\n by\n PCA<\/jats:styled-content>\n at 24\u2009h (\n MK<\/jats:styled-content>\n vs.\n ME<\/jats:styled-content>\n group, median and interquartile range) \u2013 3.43\u2009mg (1.9\u20136.5) vs. 15\u2009mg (9.65\u201317.38) (\n \n P<\/jats:styled-content>\n <\/jats:italic>\n <\u20090.001) \u2013 and at 48\u2009h \u2013 2\u2009mg (0.5\u20133.63) vs. 9.5\u2009mg (3.5\u201313.75) (\n \n P<\/jats:styled-content>\n <\/jats:italic>\n \u2009=\u20090.001). Patients in the\n MK<\/jats:styled-content>\n group also attempted less doses, at 24\u2009h: 19.5 (12.75\u201379.5) vs. 98 (41.5\u2013137) (\n \n P<\/jats:styled-content>\n <\/jats:italic>\n \u2009=\u20090.043). Both groups had similar\n NRS<\/jats:styled-content>\n values and comparable side effects.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Perioperative ketamine\u2013\n ME<\/jats:styled-content>\n combination significantly decreased opioid consumption by\n PCA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/j.1399-6576.2012.02743.x","type":"journal-article","created":{"date-parts":[[2012,7,27]],"date-time":"2012-07-27T00:25:02Z","timestamp":1343348702000},"page":"1250-1256","source":"Crossref","is-referenced-by-count":48,"title":["The perioperative combination of methadone and ketamine reduces post\u2010operative opioid usage compared with methadone alone"],"prefix":"10.1111","volume":"56","author":[{"given":"S.","family":"PACREU","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Parc de Salut Mar Universitat Aut\u00f3noma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"FERN\u00c1NDEZ CANDIL","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Parc de Salut Mar Universitat Aut\u00f3noma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"MOLT\u00d3","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Parc de Salut Mar Universitat Aut\u00f3noma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"CARAZO","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Parc de Salut Mar Universitat Aut\u00f3noma de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"FERN\u00c1NDEZ GALINSKI","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Parc de Salut Mar Universitat Aut\u00f3noma de Barcelona Barcelona 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