{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T19:00:31Z","timestamp":1770318031397,"version":"3.49.0"},"reference-count":30,"publisher":"BMJ","funder":[{"DOI":"10.13039\/100011950","name":"ITEA","doi-asserted-by":"publisher","award":["ITEA-2021-21022-RM4Health"],"award-info":[{"award-number":["ITEA-2021-21022-RM4Health"]}],"id":[{"id":"10.13039\/100011950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,1,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The perioperative use of methadone is increasing because of its favorable effects on postoperative analgesia and opioid consumption. Methadone can cause QTc interval prolongation, increasing the risk of Torsades de Pointes. The effect of an intraoperative loading dose of methadone on intraoperative QTc interval prolongation is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational cohort study of patients aged \u226518 years who underwent major non-cardiopulmonary surgery was conducted. Patients receiving an intraoperative loading dose of methadone were assigned to the methadone group; others formed the non-methadone group. Single-lead ECGs (II) were analyzed using a wavelet-based QTc interval algorithm to obtain 1-\u2009min average QTc interval values at baseline and intraoperatively. The outcome measure was the occurrence of any intraoperative 1-\u2009min averaged time windows that exceeded the predefined thresholds of 500\u2009ms (primary), increase of \u226530\u2009ms from baseline and increase of \u226560\u2009ms from baseline (secondary). Propensity score matching was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 637\u2009patients were included, and after propensity score matching (1:1 ratio), 244\u2009patients were analyzed. A QTc interval &gt;500\u2009ms (23.8% vs 23.0%; p=0.88), an increase of \u226530\u2009ms from baseline (67.8% vs 75.0%; p=0.22), and an increase of \u226560\u2009ms from baseline (29.7% vs 22.4%; p=0.21) occurred equally in the non-methadone group compared with the methadone group. The percentage of intraoperative time spent above threshold was significantly higher in the non-methadone group for the&gt;500\u2009ms threshold (p=0.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The implementation of methadone for perioperative pain management was not associated with an increased incidence of intraoperative QTc interval prolongation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2025-107331","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T15:05:30Z","timestamp":1770217530000},"page":"rapm-2025-107331","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association between intraoperative methadone administration and QTc interval prolongation: a propensity score-matched analysis"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0763-5693","authenticated-orcid":false,"given":"Jasper","family":"Koolwijk","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Babac","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands"},{"name":"Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Van \u2019t Veer","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harm J","family":"Scholten","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands"},{"name":"Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rik","family":"Vullings","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2051-5947","authenticated-orcid":false,"given":"R Arthur","family":"Bouwman","sequence":"additional","affiliation":[{"name":"Department 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