MC 5640
Stanford, CA 94305
Fax: (650) 725-8544
Indiana University School of Medicine, Indianapolis, IN, 5/13/2013
Albert Einstein College of Medicine Montefiore Medical Center, Bronx, NY, 6/30/2014
Indiana University Hospitals, Indianapolis, IN, 6/30/2017
Washington University St Louis Pediatric Anesthesiology, St Louis, MO, 7/31/2018
Anesthesia, American Board of Anesthesiology
Pediatric Anesthesia, American Board of Anesthesiology
To determine if there is an association of intraoperative methadone use and total perioperative opioid exposure in patients undergoing congenital heart surgeries.Retrospective, case-match cohort study.Single center quaternary care teaching hospital.Seventy-four patients with congenital heart disease (CHD) undergoing surgical repair or palliative surgery.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.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.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.
View details for DOI 10.1053/j.jvca.2019.09.033
View details for PubMedID 31699597