Comparison of morphine and methadone for prevention of postoperative pain in 3- to 7-year-old children
Child; Female; Male; Pain; Pain Measurement; Prospective Studies; Analysis of Variance; Double-Blind Method; Preschool; Non-U.S. Gov't; Comparative Study; Drug Evaluation; Human; Support; Postoperative/prevention & control; algorithms; Intraoperative Care; Methadone/adverse effects/pharmacokinetics/therapeutic use; Morphine/adverse effects/therapeutic use
A randomized, double-blind, prospective study was performed to determine the effects of perioperative administration of morphine or methadone on postoperative analgesic requirements and pain scores in 35 children aged 3 to 7 years undergoing major surgery. After a standardized induction of anesthesia, methadone or morphine, 0.2 mg/kg, was blindly administered, and supplemental doses were titrated to achieve comfort in the recovery room. Pain was assessed during the next 36 hours with a combination of validated behavioral and self-report measures. Patients in the methadone group required fewer supplemental opioid analgesic drugs during the next 36 hours, and reported lower pain scores. No patient had prolonged emergence from anesthesia, and no patient required naloxone or postoperative ventilatory assistance. No major adverse events occurred. We conclude that perioperative intravenous administration of methadone is an effective, inexpensive, and technologically simple means for providing prolonged analgesia for children after surgery.
1991
Berde CB; Beyer JE; Bournaki MC; Levin CR; Sethna NF
Journal Of Pediatrics
1991
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
Clinical use of methadone
Humans; Analgesics; Drug Interactions; Therapeutic Equivalency; Half-Life; Drug Administration Schedule; Pain/drug therapy; Receptors; Biological Availability; Opioid/adverse effects/pharmacokinetics/therapeutic use; Dosage Forms; Kidney Diseases/metabolism; Liver Diseases/metabolism; Methadone/adverse effects/pharmacokinetics/therapeutic use; Opioid-Related Disorders/drug therapy; Opioid/agonists; Substance Withdrawal Syndrome/etiology
Methadone hydrochloride is a mu-opioid agonist that has been used for the treatment of pain and for the management and maintenance of opioid withdrawal for over 50 years. Several characteristics make methadone a useful drug. However, these same characteristics and wide interpatient variability can make methadone difficult to use safely. A MEDLINE search was conducted on publications between January 1996 and May 2001 to identify literature relevant to this subject. Those publications were reviewed, and from them, other literature was identified and reviewed. Published studies demonstrate methadone's efficacy in pain management and in opioid withdrawal. However, interpatient variability in pharmacokinetic variables of methadone produces difficulties in developing guidelines for methadone use. Clinicians should not be deterred from use of this drug which has been shown to benefit patients in both pain management and methadone maintenance, but an individualized patient approach must be taken to use methadone safely.
2002
Layson-Wolf C; Goode JV; Small RE
Journal of Pain and Palliative Care Pharmacotherapy
2002
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1080/j354v16n01_04" target="_blank" rel="noreferrer">10.1080/j354v16n01_04</a>