{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:08:19Z","timestamp":1793916499689,"version":"4.8.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>\n                    Enhanced recovery after surgery (ERAS) protocols are standardized and designed to provide superior analgesia, reduce opioid consumption, improve patient recovery, and reduce hospital length of stay. Yet, moderate-to-severe postsurgical pain continues to afflict over 40% of patients and remains a major priority for anesthesia research. Methadone administration in the perioperative setting may reduce postoperative pain scores and have opioid-sparing effects, which may be beneficial for enhanced recovery. Methadone possesses a multimodal profile consisting of \u00b5-opioid agonism,\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    -methyl-d-aspartate (NMDA) receptor antagonism, and reuptake inhibition of serotonin and norepinephrine. Furthermore, it may attenuate the development of chronic postsurgical pain. However, caution is advised with perioperative use of methadone in specific high-risk patient populations and surgical settings. Methadone\u2019s wide pharmacokinetic variability, opioid-related adverse effects, and potential negative impact on cost-effectiveness may also limit its use in the perioperative setting. In this PRO-CON commentary article, the authors debate whether methadone should be incorporated in ERAS protocols to provide superior analgesia with no increased risks.\n                  <\/jats:p>","DOI":"10.1213\/ane.0000000000006331","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T11:23:34Z","timestamp":1686914614000},"page":"76-82","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":45,"title":["Pro-Con Debate: Role of Methadone in Enhanced Recovery After Surgery Protocols\u2014Superior Analgesic or Harmful Drug?"],"prefix":"10.1213","volume":"137","author":[{"given":"Ryan S.","family":"D\u2019Souza","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamilla","family":"Esfahani","sequence":"additional","affiliation":[{"name":"Anesthesiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren K.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Anesthesiology"},{"name":"Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,6,16]]},"reference":[{"key":"R1-20250502","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1016\/S0140-6736(06)68700-X","article-title":"Persistent postsurgical pain: risk factors and prevention.","volume":"367","author":"Kehlet","year":"2006","journal-title":"Lancet"},{"key":"R2-20250502","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1213\/01.ane.0000268145.52345.55","article-title":"Pain management: a fundamental human 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