{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T22:10:46Z","timestamp":1778623846698,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Posterior spinal fusion is the most common surgical procedure performed for correction of adolescent idiopathic scoliosis in the United States. Intraoperative methadone has been shown to improve pain control in adult patients undergoing complex spine surgery, and current pediatric studies show encouraging results; however, prospective randomized\u2010controlled trials are lacking in the pediatric literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We conducted a single\u2010center double\u2010blind randomized\u2010controlled trial to compare intraoperative use of methadone to morphine in pediatric patients undergoing posterior spinal fusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 47 adolescents undergoing posterior spinal fusion were randomized (stratified by sex) to either a methadone (<jats:italic>n<\/jats:italic>\u2009=\u200925) or morphine (<jats:italic>n<\/jats:italic>\u2009=\u200922) group. The primary outcome was postoperative opioid consumption. Secondary outcomes included postoperative pain severity, opioid\u2010related side effects, and ratio of patient\u2010controlled analgesia injections: attempts as a behavioral index of uncontrolled pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients in the methadone group consumed less total opioid postoperatively (median [interquartile range], 0.3\u2009mg\/kg [0.1, 0.5]) than patients in the morphine group (0.3\u2009mg\/kg [0.2, 0.6]), median difference [95% confidence interval] \u22120.07 [\u22120.2 to 0.02]; (<jats:italic>p<\/jats:italic>\u2009=\u2009.026). Despite the lower amount of opioid used postoperatively, pain scores for the methadone group (3.5 [3.0, 4.3]) were not significantly different from those in the morphine group (4.0 [3.2, 5.0]; <jats:italic>p<\/jats:italic>\u2009=\u2009.250). Groups did not differ on opioid\u2010related side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A two\u2010dose intraoperative methadone regimen resulted in decreased opioid consumption compared to morphine. Although the clinical significance of these results may be limited, the analgesic equipoise without increased opioid\u2010related side effects and potential for a lower incidence of chronic pain may tip the balance in favor of routine methadone use for adolescents undergoing posterior spinal fusion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14843","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T10:34:41Z","timestamp":1706610881000},"page":"438-447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Perioperative methadone for posterior spinal fusion in adolescents: Results from a double\u2010blind randomized\u2010controlled trial"],"prefix":"10.1111","volume":"34","author":[{"given":"Roger A.","family":"Fons","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin Department of Anesthesiology  Milwaukee Wisconsin USA"},{"name":"Children's Wisconsin  Wauwatosa Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1203-0157","authenticated-orcid":false,"given":"Keri R.","family":"Hainsworth","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin Department of Anesthesiology  Milwaukee Wisconsin USA"},{"name":"Children's Wisconsin  Wauwatosa Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Michlig","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin Department of Anesthesiology  Milwaukee Wisconsin USA"},{"name":"Children's Wisconsin  Wauwatosa Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Jablonski","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin Department of Anesthesiology  Milwaukee Wisconsin USA"},{"name":"Children's Wisconsin  Wauwatosa Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle L.","family":"Czarnecki","sequence":"additional","affiliation":[{"name":"Children's Wisconsin  Wauwatosa Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J.","family":"Weisman","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin Department of Anesthesiology  Milwaukee Wisconsin USA"},{"name":"Children's Wisconsin  Wauwatosa Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1025"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003517"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002808"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003025"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000281"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2017.03.007"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/00031348211054066"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-018-2541-5"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14526"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-021-00288-5"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03016318"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2011.09.004"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.2.236"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181d41dc2"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7176.116232"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318238fec5"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12021"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005366"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/pq9.0000000000000336"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000202533.05906.ea"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/2152-7806.82575"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219878135"},{"key":"e_1_2_12_24_1","unstructured":"HainsworthKR CzarneckiMC SimpsonPM et\u00a0al.Cueing medication availaibility: evidence of operant influences on patient\u2010controlled analgesia pump usage in children and adolescents.International Symposium on Pediatric Pain June 16\u201320 2019 Basel Switzerland."}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T07:24:51Z","timestamp":1714116291000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,30]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/pan.14843"],"URL":"https:\/\/doi.org\/10.1111\/pan.14843","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,30]]},"assertion":[{"value":"2023-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}