Intra-operative methadone effect on quality of recovery compared with morphine following laparoscopic gastroplasty: a randomised controlled trial
dc.contributor.author | Pontes, J. P.J. | |
dc.contributor.author | Braz, F. R. | |
dc.contributor.author | Módolo, N. S.P. [UNESP] | |
dc.contributor.author | Mattar, L. A. | |
dc.contributor.author | Sousa, J. A.G. | |
dc.contributor.author | Navarro e Lima, L. H. | |
dc.contributor.institution | Santa Genoveva Hospital Complex | |
dc.contributor.institution | Universidade Estadual Paulista (Unesp) | |
dc.contributor.institution | Queens University | |
dc.date.accessioned | 2020-12-12T01:32:15Z | |
dc.date.available | 2020-12-12T01:32:15Z | |
dc.date.issued | 2020-01-01 | |
dc.description.abstract | The effect of intra-operative intravenous methadone on quality of postoperative recovery was compared with morphine after laparoscopic gastroplasty. We included 137 adult patients with a body mass index > 35 kg.m−2 who underwent bariatric surgery. Patients were allocated at random to receive either intra-operative methadone (n = 69) or morphine (n = 68). All patients received the same postoperative care and analgesia. The primary outcome of postoperative quality of recovery was assessed using the Quality of Recovery-40 questionnaire total score 24 h after surgery. Secondary outcomes were assessed in the post-anaesthesia care unit the night of the day of surgery (T1), in the morning after surgery (T2); and at night on the day following surgery (T3). The median (IQR [range]) total Quality of Recovery-40 questionnaire score of 194 (190–197 [165–200]) was higher (p < 0.0001) in the methadone group compared with the score of 181 (174–185.5 [121–200]) in the morphine group. In the post-anaesthesia care unit, the pain burden; incidence of nausea and vomiting; rescue morphine dose; and time to discharge, were significantly lower in the methadone group. On the ward, the methadone group had a lower: incidence of rescue morphine requests at T1 (5.8 vs. 54.4%, p < 0.0001) and T2 (0 vs. 20.1%, p < 0.0001); and incidence of nausea (21.7 vs. 41.2%, p = 0.014), compared with the morphine group. We conclude that intra-operative intravenous methadone improved quality of recovery in patients who underwent laparoscopic gastroplasty, compared with intra-operative morphine. Methadone also reduced postoperative pain, postoperative opioid consumption and the incidence of opioid-related adverse events. | en |
dc.description.affiliation | Department of Anaesthesiology Santa Genoveva Hospital Complex | |
dc.description.affiliation | Botucatu School of Medicine UNESP | |
dc.description.affiliation | Department of Surgery Santa Genoveva Hospital Complex | |
dc.description.affiliation | Department of Anaesthesia Queens University | |
dc.description.affiliationUnesp | Botucatu School of Medicine UNESP | |
dc.identifier | http://dx.doi.org/10.1111/anae.15173 | |
dc.identifier.citation | Anaesthesia. | |
dc.identifier.doi | 10.1111/anae.15173 | |
dc.identifier.issn | 1365-2044 | |
dc.identifier.issn | 0003-2409 | |
dc.identifier.scopus | 2-s2.0-85088571744 | |
dc.identifier.uri | http://hdl.handle.net/11449/199157 | |
dc.language.iso | eng | |
dc.relation.ispartof | Anaesthesia | |
dc.source | Scopus | |
dc.subject | bariatric surgery | |
dc.subject | methadone | |
dc.subject | morbid | |
dc.subject | obesity | |
dc.subject | patient reported outcome measures | |
dc.subject | quality measures: patient care | |
dc.title | Intra-operative methadone effect on quality of recovery compared with morphine following laparoscopic gastroplasty: a randomised controlled trial | en |
dc.type | Artigo | |
unesp.author.orcid | 0000-0003-3428-0664[1] | |
unesp.author.orcid | 0000-0002-3575-4182[2] | |
unesp.author.orcid | 0000-0002-8549-6820[3] | |
unesp.author.orcid | 0000-0002-9135-4407[4] | |
unesp.author.orcid | 0000-0002-8365-5250[5] | |
unesp.author.orcid | 0000-0001-9596-7289[6] |