Methadone for Post-operative Spine Surgery

Primary Outcome Measures

1. Perioperative Opioid use in morphine equivalents (ME)
   perioperative opioid use (morphine equivalents (ME): intraoperative, PACU, and 72-hour totals)

Secondary Outcome Measures

1. Change in numeric rating scale (NRS) pain scores
   Pain scores recorded in the electronic medical record (EMR) using the NRS scale 0-10. A higher score indicates greater pain level. Will track scores over first 24 hours following surgery completion (as determined by PACU arrival)
2. Time in PACU
   Will measure duration of time patient spends in the PACU (measured in hours)
3. Hospital Length of Stay
   Duration of time the patient spends in the hospital. Measured in days
4. Incidence of respiratory depression
   The incidence of respiratory depression would be defined by any of the following: * respiratory rate \< 10 breaths/min for \>5 min * SpO₂ \< 90% for \>5 min (SpO₂ \<88% if history of COPD) * PaCO₂ \> 50 mmHg AND increased more than 20% of baseline (if baseline known) * Naloxone use postoperatively The following events will be documented in the electronic medical record (EMR) and study personnel will chart review for documented incidence of the criteria above and report findings. Will be reported as a "yes" or "no".
5. Incidence of Postoperative nausea and vomiting
   Incidence of postoperative nausea or vomiting will be recorded in the electronic medical record (EMR) and study personnel will chart review for documented incidence of postoperative nausea or vomiting during the first 72 hours postoperatively.
6. Patient Satisfaction
   Patient satisfaction survey will be administered by study staff 24 hours postoperatively to measure the patient satisfaction of their postoperative pain management. The survey will measure the following over the 24 postoperatively: the patients pain level on a scale from 1-10, their pain control adequacy from very poorly to very well, functional impact on getting out of bed, walking, deep breathing/coughing, physical therapy, sleeping or none, side effects of opioids including: nausea, vomiting, itching, constipation, excessive sleepiness, dizziness, or confusion, and their satisfaction level of pain management from very dissatisfied to very satisfied.