Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 29;13(17):2153.
doi: 10.3390/healthcare13172153.

The Role of Methadone in Postoperative Analgesia in Esophagectomy Patients-A Retrospective Study

Jesse Cheng  1 , Emily Peng  1 , Kaelan Wong  1 , Ricki Pad  2 , Natasha Mason  2 , Mart Andrew Maravillas  3 , Xueqin Ding  4
Affiliations

The Role of Methadone in Postoperative Analgesia in Esophagectomy Patients-A Retrospective Study

Jesse Cheng et al. Healthcare (Basel). .

Abstract

Background: Effective pain control is key to recovery after esophagectomy. Methadone may enhance analgesia and reduce opioid needs. Its role in thoracic surgery is not well defined. Methods: This single-center retrospective cohort study included 206 patients who underwent esophagectomy from 2017 to 2023. A total of 66 received intraoperative methadone, and 140 served as controls. The primary outcome was cumulative postoperative opioid use in morphine milligram equivalents (MMEs) at 12, 24, 36, 48, and 72 h. Secondary outcomes included pain scores, time to first opioid, and opioid-related side effects. Results: Demographics were similar between groups. Intraoperative opioid use was lower in the methadone group (49.9 ± 31.0 vs. 76.1 ± 39.6 MME, p < 0.001). Postoperatively, MME use was significantly lower in the methadone group at all time points: 12 h (38.4 ± 48.1 vs. 56.4 ± 53.5; p = 0.017), 24 h (76.7 ± 81.2 vs. 122.4 ± 109.7; p < 0.001), 36 h (103.8 ± 106.2 vs. 176.9 ± 156.9; p < 0.001), 48 h (139.4 ± 135.6 vs. 229.6 ± 210.7; p < 0.001), and 72 h (173.5 ± 173.5 vs. 304.0 ± 286.1; p < 0.001). Time to first opioid was longer (225.6 ± 296.5 vs. 41.6 ± 69.8 min, p < 0.001). Pain scores were similar in the first 72 h; at two weeks, they were lower with methadone (0.69 ± 1.42 vs. 1.43 ± 2.55, p = 0.009). Side effect rates were similar. Conclusions: Intraoperative methadone is associated with reduced postoperative opioid use without increasing side effects.

Keywords: esophagectomy; methadone; multimodal analgesia; opioid consumption; postoperative pain.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow Diagram for Retrospective Study.
See this image and copyright information in PMC

References

    1. Lagergren J., Smyth E., Cunningham D., Lagergren P. Oesophageal cancer. Lancet. 2017;390:2383–2396. doi: 10.1016/S0140-6736(17)31462-9. - DOI - PubMed
    1. Collaborators GBDOC The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: A systematic analysis for the global burden of disease study 2017. Lancet Gastroenterol. Hepatol. 2020;5:582–597. doi: 10.1016/S2468-1253(20)30007-8. - DOI - PMC - PubMed
    1. Furrer M., Rechsteiner R., Eigenmann V., Signer C., Althaus U., Ris H.B. Thoracotomy and thoracoscopy: Postoperative pulmonaryfunction, pain and chest wall complaints. Eur. J. Cardiothorac. Surg. 1997;12:82–87. doi: 10.1016/S1010-7940(97)00105-X. - DOI - PubMed
    1. Gottschalk A., Cohen S.P., Yang S., Ochroch E.A. Preventing and treating pain after thoracic surgery. Anesthesiology. 2006;104:594–600. doi: 10.1097/00000542-200603000-00027. - DOI - PubMed
    1. Mann C., Berlth F., Hadzijusufovic E., Lang H., Grimminger P.P. Minimally invasive esophagectomy: Clinical evidence and surgical techniques. Langenbeck’s Arch. Surg. 2020;405:1061–1067. doi: 10.1007/s00423-020-02003-w. - DOI - PMC - PubMed

LinkOut - more resources