Pediatric anesthesia & critical care
Opioid and Methadone Use for Infants With Surgically Treated Necrotizing Enterocolitis
Authors' conclusion
In this cohort study of infants with surgically treated NEC, prolonged use of nonmethadone opioids after the operation was associated with an increased likelihood of methadone treatment and increased postoperative length of stay, ventilation, and TPN use.
Study context
- Population
- Infants with surgically treated necrotizing enterocolitis (NEC), 48 Children's Hospital Association hospitals (Pediatric Health Information System (PHIS)), 2013–2022; excluded: preoperative methadone, age ≤14 days at operation, congenital heart disease-related operation, death within 90 days
- Participants
- 2,037 infants
- Exposure
- Duration of postoperative nonmethadone opioid use; methadone use vs no methadone
- Methadonen = 231
- Outcome
- Methadone use and postoperative LOS, ventilator days and TPN days
Methodological detailsmulticentre, mixed-effects multivariable logistic regression
- Multicentre
- Mixed-effects multivariable logistic regression
Main finding
As reported in the abstract
Methadone treatment and postoperative outcomes
Methadone
11.3%
231
Each group vs opioids 1 to 5 daysOdds ratio (95% CI)
Opioids 16 to 21 daysmost likely to receive methadone
11.45(6.31–20.77)
- Methadone
- more days of postoperative LOS 21.41 days (95% CI 10.81–32.02)
- Methadone
- more ventilator days 10.80 days (95% CI 3.63–17.98)
- Methadone
- more total parenteral nutrition (TPN) days 16.21 days (95% CI 6.34–26.10)
Observational data: associations, not effects.
Further findings
Postoperative nonmethadone opioid duration
- Median duration of nonmethadone opioids after operation (IQR, 6-30)
- 15 days
Methadone timing
- Median first day of methadone, POD (IQR, days 9-64)
- 18
- Median duration of methadone (IQR, 14-73)
- 28 days
Original publication
Opioid and Methadone Use for Infants With Surgically Treated Necrotizing Enterocolitis. JAMA Netw Open. Published 1 June 2023. doi:10.
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