Intraoperative Methadone is Associated with Decreased Perioperative Opioid Use without Adverse Events: A Case-Matched Cohort Study

Abstract Objective To determine if there is an association of intraoperative methadone use and total perioperative opioid exposure in patients undergoing congenital heart surgeries. Design Retrospective, case-match cohort study Setting Single center quaternary care teaching hospital Participants Seventy-four patients with congenital heart disease (CHD) undergoing surgical repair or palliative surgery Intervention Thirty-seven patients undergoing CHD surgeries receiving intraoperative methadone were matched to thirty-seven patients based upon age and procedure who did not receive intraoperative methadone. The primary study outcome was to evaluate total opioid use in intravenous milligrams of morphine equivalents per kilogram (mgME/kg) within the first 36-hours postoperatively. Mann-Whitney U test was used to compare total opioid exposure. Measurements and Main Results The total opioid use was compared between groups. The methadone cohort required less opioids intraoperatively, in the first 12 hours postoperatively, and during the first 36 hours postoperatively, (2.51 vs. 4.39 mgME/kg, p Conclusion Intraoperative methadone use was associated with a decrease in perioperative opioid exposure in patients undergoing congenital heart surgery and was not associated with adverse events or prolonged durations of mechanical ventilation or ICU stay.