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The review aims to summarize the clinical evidence on intraoperative methadone's efficacy and safety for pain management.

Intraoperative methadone: promise and pitfalls

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The review aims to summarize the clinical evidence on intraoperative methadone's efficacy and safety for pain management.
Analysis of meta-analyses and randomized controlled trials published in the last 18 months.
Evaluation of methadone's analgesic efficacy and safety profile in various surgical procedures.
Comparison of outcomes based on procedure type and multimodal strategies.
Methadone offers long-acting analgesia with opioid-sparing effects, particularly in high-pain procedures.
Safety profile shows no increased risk of respiratory depression and rare cases of clinically significant QT prolongation.
Optimal intermediate dosing of 0.15–0.25 mg kg−1 balances analgesia and recovery.

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This review summarizes methadone's analgesic efficacy and safety in perioperative settings, suggesting its role in pain management.

Praastrup et al. (2026) studied this question.

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