Pharmacokinetics of methadone in adult patients undergoing cardiac surgery with cardiopulmonary bypass

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dc.article.number10.1213/ANE.0000000000007312
dc.contributor.authorSalas, Wilbaldo E.
dc.contributor.authorCortinez, Luis Ignacio
dc.contributor.authorLópez Barreda, Rodrigo
dc.contributor.authorRolle, Augusto
dc.contributor.authorElgueta, Francisca
dc.contributor.authorGodoy, César
dc.contributor.authorGiordano Villatoro, Ady
dc.contributor.authorContreras Ibacache, Víctor
dc.contributor.authorAnderson, Brian J.
dc.date.accessioned2025-04-15T10:30:13Z
dc.date.available2025-04-15T10:30:13Z
dc.date.issued2024
dc.description.abstractCardiopulmonary bypass (CPB) induces profound physiological changes that may alter the pharmacokinetics of methadone. We aimed to describe the pharmacokinetics of an intravenous bolus of methadone racemate in adult patients undergoing heart surgery with CPB. METHODS: We prospectively studied 29 patients aged 45 to 75 years scheduled for cardiac surgery with CPB who received methadone 0.2 mg/kg after anesthesia induction. Arterial blood samples (n = 10) were taken, before, during, and after CPB. Pharmacokinetic analysis was undertaken using nonlinear mixed effects models. RESULTS: All patients completed the study. The median [interquartile range] methadone concentrations decreased from 34.8 [23.9–48.2] ng/mL (10 minutes before CPB) to 18.2 [9.9–26] ng/mL after 60 minutes of CPB (P < .001). A 3-compartment model adequately described the observed changes in methadone concentrations. The influence of CPB on methadone pharmacokinetics was best described by hemodilution in a fixed volume of 1.5 L (CPB circuit volume) and by sequestration from the CPB components (CLSEQ = 93.4 L/h, 95%CI 59–124, P < .01). The observed effect of CPB in methadone pharmacokinetics can be compensated by giving a supplementary bolus dose of 0.05 mg/kg at the end of CPB. CONCLUSIONS: Our results confirmed a decay in methadone concentrations during CPB, which, in our modeling analysis, was attributed to hemodilution and sequestration within the CPB components.
dc.description.funderEunice Kennedy Shriver National Institute of Child Health and Human Development
dc.description.funderWayne State University Perinatal Initiative in Maternal, Perinatal and Child Health
dc.description.funderNational Institutes of Health
dc.description.funderDivision of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research
dc.description.funderU.S. Department of Health and Human Services
dc.description.funderU.S. Department of Health and Human Services
dc.format.extent9 páginas
dc.fuente.origenScopus
dc.identifier.doi10.1213/ANE.0000000000007312
dc.identifier.eissn1526-7598
dc.identifier.issn15267598 00032999
dc.identifier.pubmedid7633556
dc.identifier.scopusidSCOPUS_ID:85210285405
dc.identifier.urihttps://doi.org/10.1213/ANE.0000000000007312
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/103256
dc.identifier.wosidWOS:A1995RC69000003
dc.information.autorucEscuela de Medicina; Salas, Wilbaldo E.; S/I; 237979
dc.information.autorucEscuela de Medicina; Cortinez, Luis Ignacio; 0000-0001-8544-8768; 79356
dc.information.autorucEscuela de Medicina; López Barreda, Rodrigo; 0000-0003-3144-9954; 15192
dc.information.autorucEscuela de Medicina; Rolle, Augusto; S/I; 187215
dc.information.autorucEscuela de Medicina; Elgueta, Francisca; 0000-0001-5513-7408; 167324
dc.information.autorucEscuela de Medicina; Godoy, César; S/I; 1000332
dc.information.autorucEscuela de Química; Giordano Villatoro, Ady; 0000-0002-1867-6848; 207712
dc.information.autorucEscuela de Enfermería; Contreras Ibacache, Víctor; 0000-0002-6081-0430; 101258
dc.issue.numero2
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final9
dc.pagina.inicio1
dc.relation.ispartof52nd Annual Meeting of the Society-for-Psychophysiological-Research, SEP 19-23, 2012, New Orleans, LA
dc.revistaAnesthesia & Analgesia
dc.rightsacceso restringido
dc.subjectLaudate Deum
dc.subjectLaudato Si’
dc.subjecttechnocratic paradigm
dc.subjecttheology of tecnology
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePharmacokinetics of methadone in adult patients undergoing cardiac surgery with cardiopulmonary bypass
dc.typeartículo
dc.volumen30
sipa.codpersvinculados237979
sipa.codpersvinculados79356
sipa.codpersvinculados15192
sipa.codpersvinculados187215
sipa.codpersvinculados167324
sipa.codpersvinculados1000332
sipa.codpersvinculados207712
sipa.codpersvinculados101258
sipa.indexScopus
sipa.trazabilidadCarga WOS-SCOPUS;15-04-2025
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