Methadone vs Remifentanil for Pain in Craniotomy Surgery

This trial tests two drugs, methadone and remifentanil, to determine which better manages pain after brain surgery. The goal is to assess if a single dose of methadone can control pain as effectively as remifentanil, typically administered in smaller, repeated doses. Success with methadone might reduce the need for additional pain medications post-surgery. Individuals who have undergone brain surgery and experience pain may be suitable candidates, particularly if they have not regularly used opioids before surgery. As an Early Phase 1 trial, this research aims to understand how these treatments work in people, offering participants a chance to contribute to innovative pain management strategies.

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are currently using methadone or have a chronic pain condition requiring daily opioid use.

Research has shown that both methadone and remifentanil are generally safe and effective for pain management. Studies indicate that a single dose of IV methadone during surgery is well-tolerated by patients undergoing various types of brain surgeries, with only a few side effects. Patients experienced less pain and required fewer painkillers afterward.

Research has also found remifentanil to be a safe option during surgeries, including brain surgeries, and it has been used effectively without causing major problems. This suggests that remifentanil is a good choice for controlling pain during and after surgery.

Researchers are excited about methadone for pain management during craniotomy surgery because it offers a unique approach compared to standard options like remifentanil. Unlike many anesthetics that require continuous titration, methadone allows for a single, pre-incision intravenous dose, which may streamline the anesthesia process and reduce the need for constant adjustments. Additionally, methadone has a longer-lasting effect, potentially providing more sustained pain relief post-surgery. This could lead to improved patient comfort and a smoother recovery process compared to traditional methods.

This trial will compare the effectiveness of Methadone and Remifentanil for managing pain in craniotomy surgery. Research has shown that Methadone, which participants in this trial may receive, effectively manages post-surgical pain and reduces the need for additional pain medication in various surgeries, including brain surgeries. Patients who receive Methadone report less pain and require fewer painkillers for up to 72 hours after surgery. Methadone is promising due to its long duration and ability to block certain pain signals.