None listed
Conditions
Brief summary
The aim of this study is to compare the use of intravenous methadone to morphine in improving quality of recovery, acute pain and reducing the risk of chronic pain after abdominal hysterectomy.
Interventions
Intravenous methadone loading after anaesthetic induction:
Age 18-50 20mg
Age 50-70 15mg
Age 70-80 10mg
Intravenous methadone titration in the postoperative recovery room as per hospital morphine recovery protocol (equianalgesic dosing)
Morphine patient-controlled analgesia postoperatively: 1mg bolus, 5-minute lockout, no limit for at least 24 hours
Sponsors
Monash Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. ASA I, II or III 2. Elective abdominal hysterectomy 3. Age < 80
Exclusion criteria
1. Refusal to participate 2. Unable to consent 3. Non-English speaking background with inadequate spoken English to complete questionnaire 4. Planned pelvic exenteration or radical hysterectomy 5. Adverse drug reaction to morphine or methadone, or inability to receive a volatile anaesthetic 6. Chronic pain, or taking any regular opioid or chronic pain medication preoperatively (paracetamol, NSAIDs, or tramadol is not an exclusion criteria) 7. History of intravenous drug use 8. Preoperative renal failure (with eGFR < 60 mL/min), known obstructive sleep apnoea, morbid obesity (BMI > 40 kg/m2), or severe COAD (FEV1 < 50% predicted) 9. Use of CYP 2B6 inducers or inhibitors: rifampicin, antiepileptics (carbamazepine, phenobarbital, phenytoin), sertraline, antiplatelets (clopidogrel, prasugrel, ticlopidine), antivirals (efavirenz, nevirapine) 10. Use of antipsychotic medication 11. Patients with a prolonged QT interval (> 440ms) on preoperative ECG 12. Use of selective monoamine oxidase B inhibitors: selegiline, rasagiline
Outcome results
None listed