Methadone for Emergence Delirium in Ambulatory Pediatric Strabismus Surgery

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pharmacology

Background:

• Emergence delirium is a common and concerning complication in children after strabismus surgery.
• Potential causes include visual disturbances, pain, and anesthetic agents.
• Investigating interventions to mitigate this adverse event is crucial for patient safety and recovery.

Purpose of the Study:

• To evaluate the efficacy of a single intraoperative dose of methadone in reducing emergence delirium in pediatric patients.
• To assess the impact of methadone on postoperative pain, anesthetic emergence time, and postanesthesia care unit (PACU) length of stay.

Main Methods:

• Prospective, controlled, before-and-after study design.
• Inclusion of pediatric patients (<18 years, ASA I-II) undergoing strabismus surgery.
• Administration of intravenous methadone (0.15 mg/kg) at induction in the study group versus standard care in the control group.
• Primary outcome measured by the Pediatric Anesthesia Emergence Delirium (PAED) scale.

Main Results:

• The methadone group showed significant reductions in peak (42%) and severe (85%) PAED scale scores.
• Patients receiving methadone required fewer rescue pain medications.
• No significant differences were observed in anesthetic emergence time or PACU length of stay between groups.
• No significant postoperative complications were reported.

Conclusions:

• Intraoperative methadone effectively mitigates emergence delirium in pediatric patients after strabismus surgery.
• Methadone administration did not negatively impact PACU throughput or lead to significant complications.
• Further research is recommended to support the routine use of methadone for preventing emergence delirium.