Does intravenous methadone provide longer lasting analgesia than intravenous morphine? A randomized, double-blind study

Louise Grochow, Vivian Sheidler, Stuart A Grossman, Larry Green, John Enterline

Research output: Contribution to journalArticle

Abstract

A prospective, randomized, double-blind trial was designed to compare the duration of analgesia produced by intravenous morphine and methadone. Patients with intractable cancer-related pain were studied for 5-6 days. One-eighth of the patient's daily opiate requirement was supplied as an i.v. infusion of either morphine or methadone over a period of 15 min, when initiated by the patient using a patient-controlled analgesia device. Dosing intervals, pain intensity assessments and toxicity were evaluated. Twenty-three patients were randomized; 18 were fully evaluable. Ten of the evaluable patients received morphine, 8 received methadone. Dosing intervals did not change over the 5 days for either group. The mean dosing interval for the last 10 doses was 3.9 ± 0.85 h for patients receiving morphine and 3.9 ± 1.6 h for patients receiving methadone (P = NS). One patient receiving morphine and one taking methadone required only 2-3 doses/day for pain control. Pain intensity and relief were similar for both groups. All patients had adequate analgesia as determined by at least a 50% difference in pain intensity at peak relief. The duration of pain relief when repeated intravenous doses of these analgesics were given was similar throughout the entire study period although morphine and methadone have different serum half-lives (3 vs. 25 h). Parenteral methadone does not offer a clinically significant increase in the duration of analgesia in patients with severe pain secondary to cancer.

Original languageEnglish (US)
Pages (from-to)151-157
Number of pages7
JournalPain
Volume38
Issue number2
DOIs
StatePublished - 1989

Fingerprint

Methadone
Double-Blind Method
Analgesia
Morphine
Pain
Opiate Alkaloids
Patient-Controlled Analgesia
Intractable Pain
Pain Measurement
Analgesics
Equipment and Supplies

Keywords

  • Analgesia
  • Cancer pain
  • Methadone
  • Morphine

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Neuroscience(all)
  • Neurology
  • Pharmacology
  • Clinical Psychology

Cite this

Does intravenous methadone provide longer lasting analgesia than intravenous morphine? A randomized, double-blind study. / Grochow, Louise; Sheidler, Vivian; Grossman, Stuart A; Green, Larry; Enterline, John.

In: Pain, Vol. 38, No. 2, 1989, p. 151-157.

Research output: Contribution to journalArticle

Grochow, Louise ; Sheidler, Vivian ; Grossman, Stuart A ; Green, Larry ; Enterline, John. / Does intravenous methadone provide longer lasting analgesia than intravenous morphine? A randomized, double-blind study. In: Pain. 1989 ; Vol. 38, No. 2. pp. 151-157.
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