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Methadone: applications in pediatric anesthesiology and critical care medicine

Joseph D Tobias1

  • 1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and The Ohio State University, 700 Children's Drive, Columbus, OH , 43205, USA. Joseph.Tobias@Nationwidechildrens.org.

Journal of Anesthesia
|January 12, 2021
PubMed

Insights

Methadone, a long-acting µ-opioid receptor agonist, offers versatile pain management. Its unique pharmacology also targets NMDA receptors and neurotransmitter reuptake, benefiting pediatric anesthesiology and critical care.

Area of Science:

  • Pharmacology
  • Neuroscience
  • Pain Management

Background:

  • Methadone is a pure µ-opioid receptor agonist, similar to morphine but with a significantly longer elimination half-life (24-36 hours vs. 2-3 hours).
  • Beyond µ-opioid agonism, methadone exhibits unique pharmacological actions including N-methyl-D-aspartate (NMDA) receptor antagonism and inhibition of serotonin and norepinephrine reuptake in the central nervous system.

Purpose of the Study:

  • To review the pharmacologic properties of methadone.
  • To discuss the clinical applications of methadone in pediatric anesthesiology and pediatric critical care medicine.

Main Methods:

  • Literature review of methadone's pharmacologic properties.
  • Analysis of clinical applications in pediatric pain management and critical care.

Main Results:

  • Methadone's long half-life and high oral bioavailability facilitate outpatient treatment for opioid abuse.
  • Its multifaceted pharmacology makes it effective for managing diverse acute and chronic pain conditions.

Conclusions:

  • Methadone's unique pharmacologic profile supports its use beyond opioid addiction treatment.
  • The manuscript highlights methadone's value in pediatric anesthesiology and critical care settings.
Keywords:
Acute pain managementMethadoneOpioid analgesiaOpioid dependency and withdrawal

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