Episode 262: Perioperative Methadone with Evan Kharash

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Jed Wolpaw

Health & Fitness

4.7 • 1.5K Ratings

🗓️ 28 August 2023

⏱️ 61 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this 262nd episode I welcome Dr. Evan Kharash to the show to discuss the use of methadone perioperatively instead of more commonly used opioids such as fentanyl and dilaudid. We discuss the safety of methadone, how it works, and the evidence for superiority in terms of pain control, total opioid use, and patient satisfaction.

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Transcript

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0:00.0	Hello and welcome back to ACRAC. I'm Jed Walpaw and I am really excited for today's show.
0:18.6	This is something I've been hoping to do for a while and I guess I've been really hoping to
0:21.7	have on for a while and I'm so excited that he's now here with us. I have with me Dr. Evan
0:26.3	Carish who is a professor of anesthesiology at Duke and the immediate past editor-in-chief
0:31.6	of anesthesiology. He is a well regarded well-known around the world professor and researcher
0:39.2	and one of his interests among many is methadone and it is actually true that when I heard him give a
0:45.2	talk on methadone about six months ago I came back and immediately changed my practice. It's probably
0:51.1	the most impactful talk in terms of making me change my practice right away that I've ever heard
0:55.7	and I have been trying to spread the word about methadone since but no better way to do it
1:00.4	than to have him come on the show and talk about it with me so I'm really excited for that
1:04.4	conversation. Evan thanks so much for being on the show. Jed thank you so much for having me.
1:09.2	I'm very excited to to be with you and and provide a little input wisdom and and encouragement
1:16.1	and excitement if you will to the practice and and you're getting message out to your listeners.
1:22.4	Fabulous. Well I couldn't ask you to talk a little bit about your career but obviously you have
1:27.0	such a long and storied career that we'll let people read about that separately but maybe just tell
1:30.8	us a little bit specifically about how you got interested in methadone as a drug and then some
1:36.2	of the research around it. Sure I got interested in methadone when I was an anesthesiology resident
1:44.1	and I was introduced to to the drug by an attending this was back when we often used fentanyl
1:56.2	and and even morphine in interoperative anesthesia and he walked in one day and he said what do
2:04.2	you know about methadone and I said nothing and he said would you like to give an anesthetic with
2:10.0	methadone and I said sure and like all good attendings at the same time he handed me an
2:17.6	article to read and this article was was written and published in 1982 reporting a study by
	...

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