Clinical effectiveness and safety of intraoperative methadone in patients undergoing laparoscopic hysterectomy: a randomised, blinded clinical trial
Authors' conclusion
In this randomised, blinded, controlled trial, opioid consumption was reduced during the first 24 postoperative hours in patients receiving methadone without causing an increase in adverse events.
Study context
- Population
- Patients scheduled for laparoscopic hysterectomy
- Comparison
- Intraoperative methadone 0.2 mg kg-1 vs morphine 0.2 mg kg-1
- Primary endpoint
- Opioid consumption (oral morphine equivalents, mg)
- Follow-up
- 6 and 24 h
Methodological detailsblinded
- Blinded
Primary result
As reported in the abstract
Postoperative opioid consumption · 6 h and 24 h
| Group | Value | 24 h median |
|---|---|---|
| Methadone | median 35.5 (range 0–61) mg | 42 [10-67] mg |
| Morphine | median 48 (range 31–74.5) mg | 54.5 [31-83] mg |
Value
Methadonemedian 35.5 (range 0–61) mg
Morphinemedian 48 (range 31–74.5) mg
24 h median
Methadone42 [10-67] mg
Morphine54.5 [31-83] mg
- Methadone vs Morphine: P = 0.01 — at 6 h
- Methadone vs Morphine: P = 0.03 — at 24 h
Secondary outcomes
| Outcome | Methadone | Morphine |
|---|---|---|
| Pain at rest on PACU arrival (NRS) | 3 (range 2–5) | 5 (range 3–6) |
Pain at rest on PACU arrival (NRS)
- Significantly lower with methadone
Pain at rest and coughing, rest of observation period
- Not significantly different
Other secondary outcomes (patient satisfaction, PONV) · up to 72 h
- No differences found
Original publication
Clinical effectiveness and safety of intraoperative methadone in patients undergoing laparoscopic hysterectomy: a randomised, blinded clinical trial. BJA Open. Published 5 August 2023. doi:10.
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