Subcutaneous Methadone for Cesarean Analgesia: a Non Inferiority Study Using QoR-10

This study aims to evaluate whether subcutaneous methadone provides postoperative analgesia that is non-inferior to that achieved with intrathecal morphine in women undergoing cesarean delivery under neuraxial anesthesia. The primary outcome will be the quality of postoperative recovery, assessed using the QoR-10 score during the first 24 hours after surgery. Secondary outcomes will include postoperative pain intensity, opioid consumption, incidence of adverse effects, and maternal satisfaction. This trial seeks to determine whether subcutaneous methadone could represent an alternative analgesic strategy within multimodal analgesia protocols for cesarean delivery.

Inclusion Criteria: * Women aged 18-45 years * Singleton pregnancy at term (≥37 weeks of gestation) * Scheduled for elective cesarean delivery * Planned neuraxial spinal anesthesia * Ability to understand and complete the QoR-10 questionnaire * Provision of written informed consent Exclusion Criteria: * Emergency cesarean delivery * Contraindication to neuraxial anesthesia * Known hypersensitivity or allergy to methadone or morphine * Chronic opioid use or opioid dependence