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Updated: Jul 20, 2025

An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP

Published on: January 27, 2010

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Short-acting versus long-acting opioids for pediatric postoperative pain management

Yun Han Chen1, Senthilkumar Sadhasivam1, Spencer DeMedal1

  • 1Department of Anesthesiology and Pain Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA.

Expert Review of Clinical Pharmacology
|August 2, 2023
PubMed

Insights

This review compares short- and long-acting opioids for pediatric perioperative pain. Methadone, a long-acting opioid, shows promise for improved outcomes and reduced risks compared to traditional options.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Pharmacology

Background:

  • Opioids are crucial for managing moderate to severe pediatric perioperative pain.
  • Short-acting opioids are traditionally favored due to safety concerns and limited evidence for long-acting opioids in children.
  • Methadone, a long-acting opioid, possesses unique N-methyl-D-aspartate antagonist properties.

Purpose of the Study:

  • To review and compare the evidence for short- and long-acting opioids in pediatric perioperative pain management.
  • To highlight the potential benefits of methadone in pediatric surgical pain control.
  • To address the limitations of current pain management protocols.

Main Methods:

  • Literature review and evidence synthesis.
  • Comparative analysis of commonly used short- and long-acting opioids.
  • Focus on pediatric perioperative pain management.

Main Results:

  • Short-acting opioids are commonly used, but long-acting opioids offer potential advantages.
  • Methadone's unique properties may lead to better pain relief, fewer side effects, and reduced risk of chronic pain.
  • Individualized methadone therapy, guided by pharmacogenomics, could enhance safety and efficacy.

Conclusions:

  • Methadone presents a promising alternative for pediatric perioperative pain management.
  • Personalized methadone treatment can optimize pain control and patient safety.
  • Further research and integration into enhanced recovery after surgery (ERAS) protocols are warranted.
Abstract

Keywords:
Long-acting opioidsmethadoneopioidspainpediatricpostoperative painshort-acting opioids

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