Intraoperative methadone for postoperative pain in adult patients undergoing tonsillectomy—a randomised controlled trial
Authors' conclusion
Methadone reduced opioid consumption and pain intensity but increased PONV.
Study context
- Population
- Adults undergoing elective bilateral tonsillectomy
- Participants
- 120 adults
- Comparison
- Intraoperative methadone vs fentanyl after anaesthesia induction
- Methadonen = 62
- Fentanyln = 58reference
- Primary endpoint
- Joint primary: pain intensity (NRS 0-10) at swallowing on PACU arrival; cumulative opioid consumption (oral morphine equivalents) over 5 postoperative days
Primary result
As reported in the abstract
| Group | Value | Outcome |
|---|---|---|
| Methadone | 30 (IQR 10–50) mg | cumulative 5-day opioid consumption |
| Fentanyl | 49 (IQR 29–80) mg | cumulative 5-day opioid consumption |
| Methadone | 4 (IQR 3–5) | pain intensity in postanaesthesia care unit (PACU) |
| Fentanyl | 5 (IQR 4–7) | pain intensity in PACU |
Value
Methadone30 (IQR 10–50) mg
Fentanyl49 (IQR 29–80) mg
Methadone4 (IQR 3–5)
Fentanyl5 (IQR 4–7)
Outcome
Methadonecumulative 5-day opioid consumption
Fentanylcumulative 5-day opioid consumption
Methadonepain intensity in PACU
Fentanylpain intensity in PACU
- Methadone vs Fentanyl: P = 0.002 — cumulative 5-day opioid consumption; driven by reduced use on day 1
- Methadone vs Fentanyl: P = 0.0004 — pain intensity in PACU
Secondary outcomes
| Outcome | P value |
|---|---|
| Pain intensity · 24 hLower with methadone | P = 0.005 |
| Pain intensity · 48 hLower with methadone | P = 0.03 |
Patient satisfaction, sedation, discharge times
- Did not differ significantly
Safety
Moderate to severe PONV · 24 h
P = 0.001
Moderate to severe PONV · 48 h
P = 0.005
Moderate to severe PONV · 72 h
P = 0.03
Original publication
Intraoperative methadone for postoperative pain in adult patients undergoing tonsillectomy—a randomised controlled trial. BJA Open. Published 26 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →