Efficacy of methadone for the management of postoperative pain in laparoscopic cholecystectomy: A randomized clinical trial

Abstract

Background Postoperative pain management contributes to reducing postoperative morbidity and unscheduled readmission. Compared to other opioids that manage postoperative pain like morphine, few randomized trials have tested the efficacy of intraoperatively administered methadone to provide evidence for its regular use or be included in clinical guidelines. Methods We conducted a randomized clinical trial comparing the use of intraoperative methadone to assess its impact on postoperative pain. Eighty-six patients undergoing elective laparoscopic cholecystectomy were allocated to receive either methadone (0.08 mg/kg) or morphine (0.08 mg/kg). Results Individuals who received methadone required less rescue morphine in the Post Anesthesia Care Unit for postoperative pain than those who received morphine (p = 0.0078). The patients from the methadone group reported less pain at 5 and 15 minutes and 12 and 24 hours following Post Anesthesia Care Unit discharge, exhibiting fewer episodes of nausea. Time to eye-opening was equivalent between the two groups. Conclusion Intraoperative use of methadone resulted in better management of postoperative pain, supporting its use as part of a multimodal pain management strategy for laparoscopic cholecystectomy under remifentanil-based anesthesia.

Comparative Study of Dezocine and Ketorolac Tromethamine in Patient-Controlled Intravenous Analgesia of Laparoscopic Cholecystectomy

“…However, due to factors such as diaphragm traction and visceral mucosa hypoxia after CO 2 pneumoperitoneum, patients after LC are prone to pain symptoms, which affects their physical and mental health and prognosis recovery ( 9 ). Postoperative pain can inhibit the patient's breathing activity, increase the patient's blood pressure, increase the oxygen consumption of myocardium, inhibit gastrointestinal peristalsis, reduce the body's resistance, and easily cause some negative emotions, thus affecting the prognosis of the disease ( 10 , 11 ). Therefore, how to effectively relieve postoperative pain of patients is of great significance to the physical and mental health of patients.…”