Comparing Pain Relief and Recovery After Intravenous Methadone Versus Remifentanil in Adults Undergoing Brain Surgery

What this Trial Is About

Postoperative pain is common after intracranial surgery, especially craniotomy. Patients usually receive short-acting opioids to allow early neurological exams and reduce respiratory depression risks. However, many experience moderate to severe pain within 48 hours after surgery, which can lead to complications like high blood pressure and intracranial bleeding, increasing risks of illness and death. Researchers are studying intravenous IV methadone, which has a long pain-relief effect and additional properties that may help reduce opioid needs and improve recovery after surgery. This study compares IV methadone with the usual IV remifentanil treatment in patients undergoing elective intracranial surgery to see if methadone is not worse than remifentanil for recovery quality. Participants are randomly assigned to receive either IV remifentanil with doses adjusted by the anesthesia team or a single dose of IV methadone 0.2 mgkg given before surgery starts. The trial focuses on patients having supratentorial intracranial surgery under general anesthesia. The treatments aim to manage pain during and after surgery, with methadone expected to reduce opioid use and improve pain control over the first 72 hours post-surgery. The study lasts through the immediate postoperative period, monitoring recovery and complications. During the study, participants will be assessed for quality of recovery on postoperative days 1, 2, and 3 using a questionnaire. Researchers will also measure opioid use, pain intensity scores, benefits of analgesics, complications, and hospital stay length. Pain and recovery data will be collected at specific intervals up to 72 hours after surgery. The study includes safety monitoring and aims to observe differences in recovery quality and pain control between the two treatment methods over about 3 days following surgery.

Pain Control and Quality of Recovery After Intravenous Methadone Versus Intravenous Remifentanil in Craniotomy Surgery