Sufentanil Infusion vs Intravenous Methadone for Postoperative Analgesia Following Head and Neck Dissection With Free Flap or Rotational Reconstruction

Inclusion Criteria: * • Patients undergoing head and neck dissection with free flap or rotational reconstruction at Indiana University Health Adult Academic Health Center * ASA class 1, 2, or 3 (See Appendix) * Age 18 to 80 * male or female * Able and willing to provide written informed consent Exclusion Criteria: * Any contraindication to opiates, (i.e. allergy to opioids, substance use disorder) as determined by PI review and any contraindications reported by the patient * Patient on home methadone at any dose * Any physical, mental or medical conditions which, in the opinion of the investigators, may confound quantifying postoperative pain resulting from surgery * Known true allergy to the study medications (sufentanil, methadone) * Any history of substance abuse in the past 6 months which would include heroin or any other illegal street drugs * End stage liver disease, end stage renal disease * Patient staying intubated or on mechanical ventilation after surgery * Patient (home dose) taking more than 30mg PO morphine equivalent (OME) per day * Any additional and concurrent surgical procedures to the patient