Utilization of Perioperative Methadone During Spinal Fusion

Multimodal analgesia has become a cornerstone of enhanced recovery after surgery (ERAS) protocols for spinal fusion procedures, aiming to reduce postoperative opioid requirements and improve patient outcomes. Methadone is a long-acting ?-opioid receptor agonist with N-methyl-D-aspartate (NMDA) receptor antagonism. It has reemerged as a valuable adjunct for perioperative pain management in complex spine surgery due to its unique pharmacodynamic profile and prolonged analgesic duration. This case report details the anesthetic management of a 41-year-old female undergoing an anterior approach C5-6 and C6-7-disc arthroplasty due to cervical spinal stenosis and degeneration of cervical intervertebral disc. The case focuses on perioperative anesthetic management when methadone is the only opioid utilized.