Intraoperative Methadone Cuts Post-Op Opioid Use in Spine Sx
MONDAY, May 1, 2017 -- For patients undergoing posterior spinal fusion surgery, intraoperative methadone administration is associated with reduced postoperative opioid requirements, according to a study published in the May issue of Anesthesiology.
Glenn S. Murphy, M.D., from the University of Chicago Pritzker School of Medicine in Evanston, Illinois, and colleagues conducted a parallel-group randomized trial to examine the effect of methadone on postoperative analgesic requirements, pain scores, and patient satisfaction after complex spine surgery. One hundred twenty patients undergoing posterior spinal fusion surgery were randomly allocated to receive methadone 0.2 mg/kg at the start of surgery or hydromorphone 2 mg at surgical closure.
Data were analyzed for 115 patients. The researchers found that median hydromorphone use was reduced in the methadone group on postoperative days one (4.56 versus 9.9 mg), two (0.6 versus 3.15 mg), and three (0 versus 0.4 mg). At 21 of 27 assessments, the methadone group had lower pain scores at rest, with movement, and with coughing. The methadone group had higher overall satisfaction with pain management until the morning of postoperative day three compared with the hydromorphone group.
"Intraoperative methadone administration reduced postoperative opioid requirements, decreased pain scores, and improved patient satisfaction with pain management," the authors write.
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Posted: May 2017