Anesthesia Experts

The effect of methadone on postoperative quality of recovery in patients undergoing laparoscopic cholecystectomy

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Highlights

Immediate post-op pain control remains a challenge on remifentanil anesthesia.
In this scenario, methadone was compared with morphine.
We assessed the quality of recovery (QoR-40) from both analgesia techniques.
Methadone use resulted in less sedation levels in the PACU.
There was no difference demonstrated on the QoR-40 score.
Study objectives

The aim of the present study was to assess the quality of recovery from anesthesia in patients undergoing laparoscopic cholecystectomy (LC) under total intravenous anesthesia, who received either methadone or morphine for post-surgical analgesia by means of questionnaire Quality of Recovery-40 (QoR-40).

Setting

The setting was at an operating room, postoperative recovery area and hospital ward.

Patients

Seventy patients who underwent LC under remifentanil-based anesthesia were randomly assigned to receive methadone 0.1 mg kg−1 or morphine 0.1 mg kg−1.

Measurements

The primary outcome was the quality of recovery, using the Quality of Recovery Questionnaire (QoR-40). Secondary outcomes included time to eye opening, the occurrence of nausea and vomiting, pain score, use of supplemental analgesics, and PACU length of stay.

Main results

No differences were observed in the total or individual QoR-40 dimension scores. During the PACU stay, the occurrence of PONV and pain scores were similar between groups. Opioid consumption (p < 0.02) and the level of sedation (p < 0.01) were higher in the morphine group. There were no differences in the amount of time required to achieve PACU discharge criteria. The frequency of nausea or emesis, the severity of pain, and tramadol consumption were comparable between both groups while on the ward.

Conclusions

Pain scores and the Quality of Recovery did not differ between patients who underwent LC under total intravenous anesthesia, who received either methadone or morphine for post-surgical analgesia.

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