Intraoperative Methadone Is Associated with Decreased Perioperative Opioid Use Without Adverse Events: A Case-Matched Cohort Study

Joshua D. Robinson*, Thomas J. Caruso, May Wu, Zachary I. Kleiman, David M. Kwiatkowski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective: To determine if there is an association of intraoperative methadone use and total perioperative opioid exposure in patients undergoing congenital heart surgeries. Design: Retrospective, case-match cohort study. Setting: Single center quaternary care teaching hospital. Participants: Seventy-four patients with congenital heart disease (CHD) undergoing surgical repair or palliative surgery. Intervention: Thirty-seven patients undergoing CHD surgeries receiving intraoperative methadone were matched to 37 patients based upon age and procedure who did not receive intraoperative methadone. The primary study outcome was to evaluate total opioid use in intravenous milligrams of morphine equivalents per kilogram (mg ME/kg) within the first 36-hours postoperatively. Mann-Whitney U test was used to compare total opioid exposure. Measurements and Main Results: The total opioid use was compared between groups. The methadone cohort required less opioids intraoperatively, in the first 12 hours postoperatively, and during the first 36 hours postoperatively (2.51 v 4.39 mg ME/kg, p < 0.001; 0.43 v 1.28 mg ME/kg, p = 0.001; and 0.83 v 1.91 mg ME/kg, p < 0.001) compared with the matched control cohort. There were no differences in clinical outcomes or adverse events. A dose-dependent reduction in opioid consumption in high- versus low-dose groups also was not observed. Conclusion: Intraoperative methadone use was associated with a decrease in perioperative opioid exposure in patients undergoing congenital heart surgery and was not associated with adverse events or prolonged durations of mechanical ventilation or ICU stay.

Original languageEnglish (US)
Pages (from-to)335-341
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume34
Issue number2
DOIs
StatePublished - Feb 2020
Externally publishedYes

Keywords

  • cardiac surgery
  • congenital heart disease
  • methadone
  • pediatric anesthesia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

Fingerprint

Dive into the research topics of 'Intraoperative Methadone Is Associated with Decreased Perioperative Opioid Use Without Adverse Events: A Case-Matched Cohort Study'. Together they form a unique fingerprint.

Cite this