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A combination of methadone, a synthetic opioid that acts primarily as a full μ-opioid receptor agonist, but uniquely also functions as an NMDA receptor antagonist[3][7] and inhibits serotonin and norepinephrine uptake[3], and ketamine, a noncompetitive NMDA receptor antagonist[1]. This combination has been studied for management of post-surgical pain, neuropathic pain, and as part of fast-track cardiac anesthesia protocols.
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