{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T09:20:40Z","timestamp":1780564840539,"version":"3.54.1"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T00:00:00Z","timestamp":1668124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32GM08600"],"award-info":[{"award-number":["T32GM08600"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Postoperative pain control is essential to optimizing patient outcomes, improving satisfaction, and allowing patients to resume their baseline functional activities. Methadone, a synthetic mu\u2010opioid agonist, has multiple pharmacologic properties that may be optimal for perioperative use. Compared to other opioids, methadone has a longer duration of action, rapid onset, extended dosing intervals, high oral bioavailability, low cost, lack of active metabolites, and action on multiple receptors. The current literature examining the use of methadone in the perioperative care of children and adolescents is limited and most often reported within the context of spine or cardiothoracic surgery. Overall, these studies support the hypothesis that perioperative methadone in pediatric patients may decrease postoperative pain, opioid consumption, length\u2010of\u2010stay, and the incidence of some opioid\u2010related side effects, like constipation and urinary retention. A variety of protocols for the perioperative use of methadone have been described, including a single intraoperative dose as well as multiple small doses within multimodal pain protocols. The superiority of these protocols has not been established. Like all opioids, methadone has a side effect profile which includes nausea, vomiting, reduced GI motility, sedation, and respiratory depression at high doses. There is also a concern that it can cause QTc prolongation in patients. The primary aim of this educational review is to examine the pharmacologic data, published perioperative protocols, dosing considerations, and risks and benefits associated with inclusion of methadone in analgesic regimens for surgical patients. A secondary aim is to introduce opportunities for research around the perioperative use of methadone in children and adolescents. Based on our review, we would prioritize establishing optimal procedure\u2010specific methadone protocols, determining generalizability for use in routine pediatric surgeries, and investigating methadone safety and efficacy prospectively as the primary opioid for pain management in the postanesthesia care unit or postsurgical floors.<\/jats:p>","DOI":"10.1111\/pan.14584","type":"journal-article","created":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T06:58:43Z","timestamp":1666681123000},"page":"185-192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["What we know and what we don't know about the perioperative use of methadone in children and adolescents"],"prefix":"10.1111","volume":"33","author":[{"given":"Virginie","family":"Boisvert\u2010Plante","sequence":"first","affiliation":[{"name":"McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Poulin\u2010Harnois","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesia Montreal Children's Hospital, McGill University Health Center  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6888-0102","authenticated-orcid":false,"given":"Pablo","family":"Ingelmo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesia Montreal Children's Hospital, McGill University Health Center  Montr\u00e9al Quebec Canada"},{"name":"Alan Edwards Centre for Pain Research McGill University  Montreal Quebec Canada"},{"name":"Edwards Family Interdisciplinary Complex Pain Centre, Montreal Children's Hospital McGill University Health Center  Montreal Quebec Canada"},{"name":"Research Institute of the McGill University Health Center  Montreal Quebec 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