We have recently had a few of our orthopedists and anesthesiologists inquire about using low dose methadone peri-operatively at doses of 0.1-0.3mg/kg and was curious if any of your facilities had any related experiences you'd care to share. Obviously, with methadone's t1/2 of 12-60 hours, even considering using long-acting opioids for acute pain management gives me significant pause,b ut would also be concerned about QTc effects with increased methadone use. Thoughts?

We have recently had a few of our orthopedists and anesthesiologists inquire about using low dose methadone peri-operatively at doses of 0.1-0.3mg/kg and was curious if any of your facilities had any related experiences you'd care to share. Obviously, with methadone's t1/2 of 12-60 hours, even considering using long-acting opioids for acute pain management gives me significant pause,b ut would also be concerned about QTc effects with increased methadone use. Thoughts?

Our clinical, regulatory, and legal teams are wrestling with a question that has arisen from some of the complications of COVID. Like many emergency departments, we are holding patients with complex psychiatric needs for placement at other facilities, sometimes for a week or more. Some of these patients also have opioid use disorder and are maintained on methadone. Of note, these patients are NOT admitted to our hospital and are still under the care of our ED providers.