Eficacia y perfil de seguridad de la morfina versus la metadona en el manejo del dolor postoperatorio. Revisión sistemática

Abstract

Background: Postoperative pain is a common sequela of surgical procedures, resulting from the physiological response to the manipulation of organs and tissues. Constant monitoring is essential for the patient’s complete recovery. A complete approach is needed, including opioid analgesics, NSAIDs (nonsteroidal anti-inflammatory drugs), and regional anesthesia. If not properly treated, it may become a chronic postsurgical pain, affecting the patient’s quality of life. Objective: To evaluate the efficiency and safety profile of morphine in comparison to methadone for the treatment of postsurgical pain, through a systematic review of available literature. Methodology: A systematical review was conducted, which included scientific articles selected from medical information repositories, such as Scopus, Taylor & Francis, PubMed, SciELO, and Web of Science. Keywords were also used in the research, and requirements were considered for the selection to optimize the results, including studies published within the last five years, content related to the investigation, and scientific articles with randomized trials in English and Spanish. The PRISMA 2020 methodology was used as reference, along with a quality assessment of the studies and a risk of bias analysis using the RoB2 digital tool. Discussion: Methadone supplies better analgesia and security than morphine in different surgical procedures, although some limitations exist. Conclusion: methadone is evidenced to be a more feasible and reliable option for postoperative pain treatment, offering different opportunities for analgesic efficiency and a safer profile when compared to morphine.