Intravenous Methadone Versus Intrathecal Morphine for Analgesia Following Cesarean Delivery

Intravenous Methadone Versus Intrathecal Morphine for Analgesia Following Cesarean Delivery: a Randomized Clinical Trial

The purpose of this study is to determine if there is a difference in opioid requirements at 0-48 hours after scheduled cesarean delivery in patients receiving 150 mcg intrathecal morphine compared to 0.2 mg/kg (maximum 20 mg) intravenous methadone.

Inclusion Criteria:

• English-speaking
• Age over 18 years old
• Scheduled cesarean delivery

Exclusion Criteria:

• Any contraindication to the administration of a spinal technique for anesthesia
• History of intolerance or adverse reaction to opioid medications
• History of chronic pain, opioid use >30 OME/day, or substance use disorder
• History of obstructive sleep apnea, chronic obstructive pulmonary disease, or respiratory compromise (SpO2 <92% on room air, or has a pre-existing oxygen requirement)
• History of liver or kidney failure
• Diagnosis of pre-eclampsia with current pregnancy
• Depression requiring more than one medication
• Planned use of CSE technique
• BMI >50.0 kg/m2
• ASA status IV, V
• No prior history of an ECG demonstrating QTc > 440ms
• Surgical complication requiring conversion to general anesthesia