This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shir, Y. Articles by Davidson, E. M. Search for Related Content PubMed PubMed Citation Articles by Shir, Y. Articles by Davidson, E. M.

Methadone is safe for treating hospitalized patients with severe pain

[La méthadone est sans danger chez les patients hospitalisés qui éprouvent des douleurs intenses]

From the Pain Relief Unit, Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, Jerusalem, Israel.

Dr. Yoram Shir, Pain Relief Unit, Department of Anesthesiology, Hadassah University Hospital, Jerusalem 91120, Israel. Phone: +9722-6776911; Fax: +9722-6429392; E-mail: yshir{at}hadassah.org.il

Purpose: Methadone is still regarded as a second line opioid for patients suffering from severe pain, and is rarely used in hospitalized patients. The infrequent use of methadone is probably due to its long plasma half-life that could lead to accumulation and toxicity. In the present study we report that clinically effective analgesic doses of methadone, given either epidurally or orally, can be used safely for prolonged treatment in hospitalized patients.

Clinical features: Over a five-year period we administered methadone at Hadassah Hospital in Jerusalem to 3,954 in-patients with severe pain, 12% of whom were younger than 17 yr. Satisfactory pain relief was recorded in more than 85% of the patients. None of the patients treated with oral methadone developed serious side effects. Three patients, treated with epidural methadone (0.09%), developed a clinically significant respiratory depression. In all three cases, epidural pump failure or pump misprogramming resulted in methadone overdose. None of the children or adults treated with methadone developed addiction during hospitalization.

Conclusion: Based on its analgesic properties and marked safety profile, we suggest that methadone could be added to the analgesic armamentarium of in-hospital health-care providers. Moreover, methadone could serve as the opioid of first choice in some in-patient populations.

This article has been cited by other articles:

				P. W. H. Peng, P. S. Tumber, and D. Gourlay Review article: Perioperative pain management of patients on methadone therapy: [Expose de synthese : Traitement de la douleur perioperatoire chez les patients sous therapie a la methadone] Can J Anesth, May 1, 2005; 52(5): 513 - 523. [Abstract] [Full Text] [PDF]

				M. F. Ballesteros, D. S. Budnitz, C. P. Sanford, J. Gilchrist, G. A. Agyekum, and J. Butts Increase in Deaths Due to Methadone in North Carolina JAMA, July 2, 2003; 290(1): 40 - 40. [Full Text] [PDF]