methadone / Generic mfg. - LARVOL DELTA

When methadone fails in cancer pain management. A retrospective analysis. (PubMed, J Pain Symptom Manage) - "OS from methadone was effective in most cases, but the treatment was challenging as higher doses of opioids are expected, due to the loss of the extra-opioid analgesic effects of methadone."

Journal • Retrospective data • Oncology • Pain • Palliative care

Opioid agonist therapy adherence trajectories among commercially and publicly insured people living with Hepatitis C in the United States. (PubMed, Epidemiology) - "These results may inform support for populations with elevated baseline risk of low opioid agonist therapy adherence during follow-up."

Journal • Hepatitis C • Infectious Disease • Inflammation • Pain • Substance Abuse

Impact of Asynchronous Training on Student's Confidence and Attitudes Regarding Patients With Opioid Use Disorders. (PubMed, Subst Use Addctn J) - "Asynchronous learning modules can be effectively implemented in medical and nursing education to improve confidence and attitudes regarding the CP-OUD. The use of asynchronous training modules allows for flexible deployment, as evidenced by their use in 3 MD programs and a GSN program. Future research should investigate whether improved confidence and attitudes during medical and nursing education result in more graduates caring for patients with OUD post-training."

Journal • Addiction (Opioid and Alcohol) • Psychiatry • Substance Abuse

Buprenorphine Versus Methadone in Female New Zealand White Rabbits Undergoing Balanced Anaesthesia for Calvaria Surgery. (PubMed, Animals (Basel)) - "Forty-eight female New Zealand white rabbits undergoing calvaria defects were randomly equally assigned to receive either 0.03 mg kg-1 of buprenorphine (group B) or 0.3 mg kg-1 of methadone (group M) in combination with 15 mg kg-1 of ketamine and 0.1 mg kg-1 of dexmedetomidine SC. Rabbits of both groups showed short-term respiratory acidosis. RbtGS scores indicated better and longer analgesia in group B compared to group M."

Journal • Preclinical • Anesthesia • Metabolic Disorders • Pain

Investigating Endogenous Opioids Unravels the Mechanisms Behind Opioid-Induced Constipation, a Mathematical Modeling Approach. (PubMed, Int J Mol Sci) - "We study the effects of Morphine, Fentanyl, and Methadone and contrast them with Endomorphin-2. This finding shows that modulating opioid degradation rates significantly improves cAMP recovery. In conclusion, our insights steer towards exploring opioid degrading enzymes, localized to the gut, as a strategy for mitigating OIC."

Journal • Constipation • Gastroenterology • Gastrointestinal Disorder

ST301. The Value of Regional Anesthesia in Cardiothoracic Surgery and the EP Lab (1 CME) (ASA 2025) - "It will also discuss the role of methadone in cardiac surgery as well as the role of cryoablation in thoracic surgery. SessionLearningObjective1: Discuss the benefits of regional anesthesia in cardiac surgery and electrophysiology procedures.SessionLearningObjective2: Discuss the role of methadone in open cardiac surgery.SessionLearningObjective3: Discuss the benefits of regional anesthesia and cryoablation in thoracic surgery."

Surgery • Anesthesia • Cardiovascular

The Value of Methadone in Cardiac Surgery (ASA 2025) - "There is no abstract associated with this presentation."

Surgery • Cardiovascular

RL301. Opioid Agonists and Antagonists: Management in the Perioperative Period: The Role of the Anesthesiologist (1 CME) (ASA 2025) - "This refresher course lecture will provide an overview of managing OUD patients in the perioperative setting by providing recommendations for the preop, periop, and postop periods, and review the recently published recommendations on perioperative management of patients on medications for opioid use disorder (MOUD). SessionLearningObjective1: Describe the conundrum of comanaging OUD and perioperative pain.SessionLearningObjective2: Describe the pharmacology of the three FDA-approved medications for OUD: Methadone, buprenorphine, and naltrexone.SessionLearningObjective3: Apply the latest concepts in perioperative management of the patient with OUD on MOUD."

Anesthesia • Pain • Substance Abuse

Intraoperative Single Dose of Methadone and Its Impact on Postoperative Pain Management for Lumbar Fusion Spine Surgery (ASA 2025) - "Abstract is embargoed at this time."

Surgery • Orthopedics • Pain

PN306. Goldilocks in the ICU: Navigating Pain, Analgesia and Opioid Use Disorder (1 CME) (ASA 2025) - "Additionally, we will review the current literature and guidelines for opioid-based sedation and analgesia in the ICU, while also examining acquired opioid dependence and chronic pain disorders as potential unintended consequences of ICU admission. SessionLearningObjective1: To provide guidance on the treatment of acute pain in critically ill patients actively misusing opioids, or receiving buprenorphine, methadone, or naltrexone as OUD treatment.SessionLearningObjective2: To present contemporary literature and guideline-based strategies for sedating the mechanically ventilated ICU patient and examine the clinical impacts of analog- and nonsedation.SessionLearningObjective3: To understand the prevalence of acquired opioid dependence and chronic pain disorders after ICU stay and provide strategies that reduce the risk of post-ICU opioid dependence."

Addiction (Opioid and Alcohol) • Anesthesia • Pain • Substance Abuse

UNDERSTANDING THE IMPACT OF INTRAOPERATIVE SINGLE-DOSE METHADONE ON PERIOPERATIVE PAIN MANAGEMENT FOLLOWING PEDIATRIC TONSILLECTOMY (ASA 2025) - "Abstract is embargoed at this time."

Clinical • Pain • Pediatrics

The role of Methadone in postoperative analgesia in Esophagectomy Patients - A Retrospective Study (ASA 2025) - "Abstract is embargoed at this time."

Retrospective data • Anesthesia • Pain

Evaluating Respiratory Depression after Methadone Administration in Perioperative Care: A Meta-analysis (ASA 2025) - "Abstract is embargoed at this time."

Retrospective data • CNS Disorders • Depression • Mood Disorders • Psychiatry

Postoperative naloxone administration after perioperative methadone: A retrospective analysis (ASA 2025) - "Abstract is embargoed at this time."

Retrospective data

Methadone Conversion in Pediatric Patients with Complex Acute Pain & Iatrogenic Opioid Dependence After Critical Illness: A QI Study (ASA 2025) - "Abstract is embargoed at this time."

Clinical • Addiction (Opioid and Alcohol) • Pain • Pediatrics

Intraoperative Methadone Versus Non-Methadone Analgesia in Pediatric Cardiac Surgery Requiring Cardiopulmonary Bypass (ASA 2025) - "Abstract is embargoed at this time."

Clinical • Surgery • Cardiovascular • Pediatrics

PN308. Opioid Use Disorder in Pregnancy: Antepartum, Intrapartum, and Postpartum Management Strategies (1 CME) (ASA 2025) - "The learner will achieve a detailed review of the pharmacology and evidence behind use of medication assisted therapy in pregnancy as well as learn labor and surgical anesthesia pain management strategies. SessionLearningObjective1: Discuss the prevalence of opioid use disorder in pregnancy and implications for maternal and fetal morbidity.SessionLearningObjective2: Review pharmacologic therapies for opioid dependence (methadone, buprenorphine) and define a practical approach of managing these drugs in pregnancy, labor, and perioperatively.SessionLearningObjective3: Discuss the use of effective non-opioid pain management strategies in this vulnerable population including low thoracic epidurals, TAP/QL blocks, and adjuncts."

Addiction (Opioid and Alcohol) • Anesthesia • Pain • Substance Abuse

Multimodal Analgesic Regimen for Left Thoracotomy (ASA 2025) - "Ketamine and methadone were agents given intraoperatively. This strategy resulted in effective analgesia that eliminated postoperative opioid consumption. The nerve blocks employed were technically straightforward and represent alternatives to more challenging techniques, such as thoracic epidural or paravertebral blocks."

Pain

Clinical Effectiveness and Safety of Intraoperative Methadone in Patients Undergoing Orthopedic and/or Neurological Spine Surgeries (ASA 2025) - "We aim to increase the use of methadone in patients undergoing spine surgery from 0% to 20% by April 2025. This initiative not only benefits spine patients, but has broader benefits for other large surgical procedures and other healthcare institutions."

Clinical • Surgery • CNS Disorders • Depression • Orthopedics • Pain • Psychiatry

Hemodynamic Stability with Methadone During Craniotomy in a Patient with HOCM: A Novel Anesthetic Approach (ASA 2025) - "Following severe hypotension with conventional opioids during a prior attempt, a methadone-based strategy—augmented with esmolol, ketamine, and TEE monitoring—resulted in markedly improved hemodynamic stability and no appreciable SAM on intraoperative TEE. Methadone's long-acting μ-opioid agonism and NMDA antagonism offer advantages in patients with cardiovascular comorbidities. This case supports methadone as a hemodynamically favorable alternative in neurosurgery and warrants further study in high-risk populations."

Clinical • Anesthesia • Cardiomyopathy • Cardiovascular • Hypertrophic Cardiomyopathy • Hypotension • Obstructive Hypertrophic Cardiomyopathy

The Diagnostic and Therapeutic Challenge of Kratom Withdrawal: A Post-Transplant Case Managed with Methadone (ASA 2025) - "Poorly controlled postoperative pain in a liver transplant recipient, despite multimodal analgesia (PCA opioids, ketamine, nerve blocks), prompted further investigation revealing daily kratom use. Suspected kratom withdrawal, similar to opioid withdrawal and tolerance, was successfully managed with methadone, achieving significant pain relief and patient satisfaction. The challenge of recognizing kratom dependence in the perioperative setting is amplified by its widespread use, and highlights the critical need for standardized protocols to identify and manage it early while preventing unnecessary opioid escalation."

Clinical • Post-transplantation • Addiction (Opioid and Alcohol) • Pain • Transplantation

POUNCE syndrome after accidental ingestion of methadone in a unsupervised 2-year-old (ASA 2025) - "He underwent decompressive surgery and EVD placement. A repeat brain MRI revealed toxic leukoencephalopathy of the bilateral cerebellum and hippocampi which is consistent with Pediatric opioid‑use‑associated neurotoxicity with cerebellar edema (POUNCE) syndrome."

CNS Disorders • Musculoskeletal Diseases • Orthopedics • Pediatrics • Ventriculomegaly

Anesthetic Management of a Patient with Propofol Infusion Syndrome Requiring Intraoperative Neuromonitoring (ASA 2025) - "Therefore, we opted to use ketamine, midazolam, remifentanil, methadone and 0.2 MAC sevoflurane instead. Using this combination of medications we were able to obtain strong, reliable SSEP and MEP signals and the patient showed no indications of awareness or discomfort."

Clinical • Anesthesia • Cardiomyopathy • Cardiovascular • Pain

Repeated Neuraxial Analgesia and Multimodal Pain Control in a Postpartum Patient with Multiple Limb Ischemia (ASA 2025) - "Methadone and ketamine were chosen for analgesia and mood stabilization, addressing the psychological impact of postpartum status and prolonged critical illness. This case highlights the safety of repeated neuraxial techniques and the value of a multidisciplinary, patient-centered pain management approach."

Clinical • Cardiovascular • Pain • Septic Shock

Torsades in Transplantation: Methadone-Associated QT Prolongation and Ventricular Arrhythmias During Liver Transplantation (ASA 2025) - "Post-reperfusion cardiac arrest associated with profound hypothermia responded to epinephrine. Postoperative QTc peaked at 746ms. The combination of methadone, impaired hepatic clearance, anesthetic factors, and genetic predisposition led to prolonged QT, triggering the fatal arrhythmia."

Anesthesia • Cardiovascular • Hepatology • Liver Failure • Transplantation