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Efficacy and safety of intraoperative intravenous methadone during general anaesthesia for caesarean delivery: a retrospective case-control study.
MedLine Citation:
PMID:  23219678     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Most patients undergoing caesarean delivery with general anaesthesia require systemic opioid administration. Due to its rapid onset and long duration of action, intravenous methadone may make it suitable for analgesia after caesarean delivery. Intraoperative methadone combined with postoperative intravenous patient-controlled analgesia with fentanyl or morphine has recently been introduced in our unit. METHODS: A retrospective case-control study of 25 patients who had received methadone was performed. Fifty control patients undergoing elective or emergency caesarean delivery were matched for the use of postoperative intravenous patient-controlled analgesia, transversus abdominis plane (TAP) block and regular non-steroidal anti-inflammatory drugs. Exclusion criteria included preoperative neuraxial analgesia or pre-delivery opioid consumption greater than 10mg of intravenous morphine equivalents. RESULTS: Patients in the methadone group had lower pain scores and were less likely to require intravenous opioid supplementation in the post-anaesthetic care unit (P<0.001). Opioid consumption over 48h was significantly lower in the methadone group. Delayed discharge from the post-anaesthesia care unit was due to sedation in one patient in the methadone group compared to three control patients in whom it was due to sedation and inadequate analgesia. CONCLUSION: A single intraoperative bolus of intravenous methadone appeared to provide effective analgesia with an acceptable side-effect profile.
Authors:
T Russell; C Mitchell; M J Paech; T Pavy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-6
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  -     ISSN:  1532-3374     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ltd.
Affiliation:
Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia; Department of Anaesthesia, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. Electronic address: twain.russell@health.wa.gov.au.
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