Evaluation of an opiate-weaning protocol using methadone in pediatric intensive care unit patients

To evaluate the efficacy of a standardized opiate-weaning protocol using methadone compared with methadone weaning before protocol development. Time series, prospective study with comparison to historical controls. Twenty-bed medical-surgical intensive care unit in an academic children's hospital. Ten children, aged 6 months to 18 yrs, who received methadone for weaning from continuous opiate infusions for >or=7 days compared with ten patients undergoing weaning by standardized protocol. Institution of standardized opiate-weaning protocol. Patient age, gender, and diagnosis were similar in both nonprotocol (NP) and protocol (P) groups (p = NS). Days of opiate use were also similar between groups. Nine of ten NP and seven of ten P patients were on continuous fentanyl infusions, and the remainder were on continuous morphine infusions. P patients were weaned significantly faster than NP patients (median, 9 days and 20 days, respectively; p