Preoperative characteristics and opioid usage.

ObjectiveTo compare efficacy of oral versus intravenous (IV) methadone on postoperative pain and opioid requirements after spine surgery.MethodsThis was a retrospective, single-academic center cohort study evaluating 1010 patients who underwent >3 level spine surgery from January 2017 to May 2020 and received a one-time dose of oral or intravenous methadone prior to surgery. The primary outcome measured was postoperative opioid use in oral morphine equivalents (ME) and verbal response scale (VRS) pain scores up to postoperative day (POD) three. Secondary outcomes were time to first bowel movement and adverse effects (reintubation, myocardial infarction, and QTc prolongation) up to POD 3.ResultsA total of 687 patients received oral and 317 received IV methadone, six patients were excluded. The IV group received a significantly greater methadone morphine equivalent (ME) dose preoperatively (112.4 ± 83.0 mg ME versus 59.3 ± 60.9 mg ME, p ConclusionsOral methadone is a feasible alternative to IV methadone for patients undergoing spine surgery regarding both pain scores and postoperative opioid consumption.

【研究目的】比较口服与静脉（intravenous，IV）美沙酮对脊柱手术后疼痛控制效果及术后阿片类药物需求量的影响。
【研究方法】本研究为回顾性单学术中心队列研究，纳入2017年1月至2020年5月期间接受3节段以上脊柱手术、且术前单次给予口服或静脉美沙酮的1010例患者。本研究的主要结局指标为术后3天（postoperative day，POD）内以口服吗啡当量（oral morphine equivalents，ME）计算的术后阿片类药物使用总量，以及语言评定量表（verbal response scale，VRS）疼痛评分。次要结局指标为术后首次排便时间，以及术后3天（postoperative day，POD）内的不良事件（再插管、心肌梗死及QT间期延长）。
【研究结果】最终共有687例患者接受口服美沙酮，317例接受静脉美沙酮，另有6例患者被排除。静脉组术前美沙酮的口服吗啡当量（ME）剂量显著更高（112.4 ± 83.0 mg ME 对比 59.3 ± 60.9 mg ME，p）
【研究结论】口服美沙酮可作为脊柱手术患者静脉美沙酮的可行替代方案，无论在疼痛评分还是术后阿片类药物消耗量方面。