Intraoperative Methadone Administration for Improved Pain Control in Spinal Fusion Patients
Status:
Completed
Trial end date:
2020-11-10
Target enrollment:
Participant gender:
Summary
Methadone has several advantages over standard narcotic medications, especially when
considering use after a typically painful surgery such as lumbar fusion. Methadone is low
cost, has a long half-life, has a convenient dosing schedule, has excellent oral
bioavailability, and demonstrates slow onset to withdrawal. The literature comparing
methadone to more commonly used post-operative narcotics demonstrates that it manages pain
better, sustains consistent plasma concentrations, decreases overall narcotic requirement,
results in no additional adverse events, and is safe, even in children, across several
studies. Since the standard of care is non-methadone narcotic usage to manage the significant
pain of complex spinal surgery cases, it is understandable that methadone could be a
desirable alternative to promote sustained pain control and early ambulation in these
patients. The goal of this study is to compare the effect of a single dose of methadone
administered intraoperatively in enrolled spinal fusion patients to their historical controls
given fentanyl and morphine, and determine if more sustained pain control during the first
few days after surgery provides a better subjective experience for the patient with less
pain, which allows them to ambulate and leave the hospital sooner than patients given a
standard regimen.