{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:19:32Z","timestamp":1787908772016,"version":"build-2784847793"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF18C0052692"],"award-info":[{"award-number":["NNF18C0052692"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative pain management is a challenge after robot\u2010assisted cystectomy (RAC). Methadone has a long duration of action, and we therefore hypothesized that a single dose of intraoperative methadone would reduce postoperative opioid requirements and pain intensity in bladder cancer patients undergoing RAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a blinded randomized controlled clinical trial from July 2020 to August 2023. Patients scheduled to undergo RAC because of bladder cancer were randomized to receive intraoperative methadone (0.15\u2009mg\/kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) or morphine (0.15\u2009mg\u2009kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) 1\u2009h before endotracheal extubation. The primary outcome was opioid requirements after 24\u2009h. Secondary outcomes were opioid requirements after 3\u2009h, pain intensity at rest and during coughing, postoperative nausea and vomiting (PONV), sedation, hypoxemia, hypoventilation, time spent in the post\u2010anesthetic care unit, and patient satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 114 patients were randomized. Data from 99 patients (14 females, 85 males; mean age 69.8\u2009\u00b1\u20098.9\u2009years) were available for analysis; 52 received methadone and 47 received morphine. Opioid consumption was similar between the methadone group and morphine group at 3\u2009h (median, mg, 45 (IQR 30 to 75) vs. 45 (IQR 15 to 82.5)\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.97) and at 24\u2009h (median, mg, 125 (IQR 75 to 198.5) versus 105 (IQR 72 to 157.5),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.29). Pain intensity was significantly lower in the morphine group at 48\u2009h compared with the methadone group. Patient satisfaction at 24\u2009h was increased in the methadone group compared with the morphine group (median, (IQR), NRS; 9 (IQR 7 to 10) versus 7 (IQR 4 to 9),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.020). There were no differences between treatment groups in terms of time spent in the post\u2010anesthetic care unit and the occurrence of opioid\u2010related side effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A single dose of intraoperative methadone does not reduce postoperative opioid requirements compared with a single dose of morphine in bladder cancer patients undergoing RAC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.14545","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T04:28:19Z","timestamp":1730953699000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of intraoperative methadone in robot\u2010assisted cystectomy on postoperative opioid requirements: A randomized clinical 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