Intraoperative Methadone Versus Other Opioids: A Retrospective Review of Postoperative Outcomes in Pediatric Surgeries

Author: Pan Stephanie J., et al.

Anesthesia & Analgesia ():10.1213/ANE.0000000000007653, July 31, 2025. doi:10.1213/ANE.0000000000007653

Summary
Pan and colleagues conducted a retrospective cohort study of 1794 pediatric patients undergoing six common surgeries to evaluate intraoperative methadone use compared with other opioids. Of these, 528 received methadone. Methadone was associated with lower maximum PACU pain scores (3.9 vs 4.5), reduced PACU opioid consumption, and decreased incidence of emergence delirium (9.6% vs 16.9%). There were no significant differences in naloxone administration, postoperative nausea and vomiting, or PACU length of stay.

Practical implications

1. Methadone may provide superior analgesia compared to other opioids in pediatric surgery.

2. Intraoperative methadone use could reduce postoperative opioid needs and emergence delirium.

3. Further large-scale studies are needed to fully assess safety and rare adverse events in children.

References
Author: Pan Stephanie J., et al.
Anesthesia & Analgesia ():10.1213/ANE.0000000000007653, July 31, 2025. doi:10.1213/ANE.0000000000007653

Thank you to Anesthesia & Analgesia for allowing us to reference this article.