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[https://ovidsp-dc2-ovid-com.ezproxy.lib.utah.edu/ovid-new-a/ovidweb.cgi?WebLinkFrameset=1&S=828c5f44-ae52-45b8-81d6-fb8b88a3683d%7cmain&returnUrl=ovidweb.cgi%3f%26Titles%3dS.sh.92%257c21%257c100%26FORMAT%3dtitle%26FIELDS%3dTITLES%26S%3d828c5f44-ae52-45b8-81d6-fb8b88a3683d%257cmain&fromjumpstart=0&directlink=https%3a%2f%2fovidsp.dc2.ovid.com%2fovftpdfs%2fFPEBIPGHJEIKGD00%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022.pdf&filename=Prolonged+Depression+of+Respiratory+Rate+Following+Methadone+Analgesia.&navigation_links=NavLinks.S.sh.92.21&PDFIdLinkField=%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022&link_from=S.sh.92%7c21&pdf_key=B&pdf_index=S.sh.92&D=medall Case report from 1976] showed that single dose of IV methadone could lead to prolonged respiratory depression. Here's the thing though, it was an 81 year old woman who was 43 kg and getting an open aortic valve replacement, in addition to 3 mg of morphine, she also got 30 mg of IV methadone!
[https://ovidsp-dc2-ovid-com.ezproxy.lib.utah.edu/ovid-new-a/ovidweb.cgi?WebLinkFrameset=1&S=828c5f44-ae52-45b8-81d6-fb8b88a3683d%7cmain&returnUrl=ovidweb.cgi%3f%26Titles%3dS.sh.92%257c21%257c100%26FORMAT%3dtitle%26FIELDS%3dTITLES%26S%3d828c5f44-ae52-45b8-81d6-fb8b88a3683d%257cmain&fromjumpstart=0&directlink=https%3a%2f%2fovidsp.dc2.ovid.com%2fovftpdfs%2fFPEBIPGHJEIKGD00%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022.pdf&filename=Prolonged+Depression+of+Respiratory+Rate+Following+Methadone+Analgesia.&navigation_links=NavLinks.S.sh.92.21&PDFIdLinkField=%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022&link_from=S.sh.92%7c21&pdf_key=B&pdf_index=S.sh.92&D=medall Case report from 1976] published in Anesthesiology showed that single dose of IV methadone could lead to prolonged respiratory depression. Here's the thing though, it was an 81 year old woman who was 43 kg and getting an open aortic valve replacement, in addition to 3 mg of morphine, she also got 30 mg of IV methadone!
[https://journals-lww-com.ezproxy.lib.utah.edu/anesthesiology/pdf/10.1097/00000542-198212000-00005~pharmacodynamics-and-pharmacokinetics-of-methadone-during A 1982 study] published in Anesthesiology reported that 23 general surgery and orthopedic patients were given 20 mg IV methadone bolus at induction, 100% required no additional opioids in the first 18 hrs post-op. 25% required only non-opioid analgesics. 40% did not need any additional treatment for post-op pain. There was no respiratory depression.