Introduction

Methadone is increasingly used in perioperative settings

This study examines the current patterns of perioperative methadone use in the United States

Methadone is increasingly used in perioperative settings

This study examines the current patterns of perioperative methadone use in the United States

Methods

Premier Healthcare database

Institutions conducting at least 10 of the following procedures annually: spinal fusions, primary THA, revision THA, primary TKA, and revision TKA.

We report the proportion of patients (%) receiving perioperative methadone per procedure group.

Hospital-level procedure-specific utilization was reported grouped by surgery type and categorized into

Results

The use of perioperative methadone varied significantly across institutions and procedure types

Spinal fusions

345 institutions did not use perioperative methadone

135 administered it to ˂ 1% of patients

153 used it for 1–25% of patients

12 prescribed it to ≥ 26%

THA

388 institutions reported no use

436 used it for ˂ 1% of patients

109 prescribed it to 1–25%

1 institution prescribed it to ≥ 26%

THA revisions

348 institutions did not use methadone,

19 administered it to ˂ 1% of patients

108 prescribed it to 1–25%

1 institution used it for ≥ 26%

TKA

373 institutions reported no usage

517 prescribed it to ˂ 1% of patients

71 used it for 1–25%

1 institution prescribed it to ≥ 26%

TKA revisions

501 institutions reported no use

100 used it for ˂ 1% of patients

141 prescribed it to 1–25%

1 institution used it for ≥ 26%

Discussion

Methadone utilization can be a valuable tool in peri- and postoperative management, offering potentially enhanced pain control and could benefit opioid sparing strategies. Our descriptive analysis of its perioperative usage showed low numbers around the country. Its utilization varies widely across institutions and procedures, likely reflecting differences in provider and individual preferences. Further prospective research on perioperative methadone usage is crucial to evaluate trends and benefits on pain management and postoperative opioid requirements.