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Methadone patient-controlled analgesia for postoperative pain: a randomized, controlled, double-blind study

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Abstract

Purpose

Postoperative pain is an important health-care issue. Patient-controlled analgesia (PCA) is considered the gold standard for systemic postoperative pain treatment. Methadone PCA is used for patients with chronic pain and those in the palliative care setting. However, its efficacy as a first-line drug for acute postoperative pain is unknown. This study evaluated the use of postoperative methadone PCA after total hip arthroplasty (THA) compared with morphine PCA.

Methods

This was a randomized, double-blind, controlled, parallel-group study. Patients were randomized into two groups: group methadone—methadone PCA, and group morphine—morphine PCA, for postoperative analgesia. Drugs were delivered through PCA pumps throughout the first 24 h after surgery (T1:6, T2:12, T3:18, T4:24 h).

Results

Opioid consumption in 24 h was significantly lower for group methadone than for group morphine. Group methadone patients experienced significantly less pain than group morphine at rest. Pain after movement was significantly lower in group methadone at T1 and T3 and marginally lower at T2 and T4. Adverse events more frequently reported were sleepiness, nausea, and vomiting, but no statistical difference between groups was found.

Conclusion

This study demonstrated that methadone PCA prompted less opioid consumption and lower pain scores at rest and at motion in comparison with morphine PCA as postoperative analgesia after THA.

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Acknowledgments

Methadone hydrochloride (racemic mixture) and morphine sulphate were provided from Cristália Prod. Quím e Farm LTDA (Itapira, SP, Brazil).

Conflict of interest

None.

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Authors and Affiliations

  1. Institute of Cancer, University of São Paulo School of Medicine, São Paulo, SP, Brazil

    José Osvaldo Barbosa Neto

  2. Pain Control Group, Hospital das Clínicas, University of São Paulo School of Medicine, Rua Sabará, 427, apto 82, São Paulo, SP, Brazil

    Maria Deneb Tavares Machado, Marta de Almeida Correa, Irimar Paula Posso & Hazem Adel Ashmawi

  3. University of São Paulo School of Medicine, São Paulo, SP, Brazil

    Hamilton Alves Scomparim

Authors
  1. José Osvaldo Barbosa Neto
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  2. Maria Deneb Tavares Machado
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  3. Marta de Almeida Correa
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  4. Hamilton Alves Scomparim
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  5. Irimar Paula Posso
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  6. Hazem Adel Ashmawi
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Corresponding author

Correspondence to Hazem Adel Ashmawi.

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Neto, J.O.B., Machado, M.D.T., de Almeida Correa, M. et al. Methadone patient-controlled analgesia for postoperative pain: a randomized, controlled, double-blind study. J Anesth 28, 505–510 (2014). https://doi.org/10.1007/s00540-013-1785-3

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  • DOI: https://doi.org/10.1007/s00540-013-1785-3

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