Evaluating the Effect of Preoperative Duloxetine Administration on Postoperative Pain in Patients under Abdominal Hysterectomy

Abstract

BACKGROUND AND OBJECTIVE: Postoperative pain management is considered as a part of recovery. Duloxetine (DLX), an anti-depressant medication, is a possible choice for the multimodal anesthetic strategy. We aimed to evaluate the effect of Duloxetine on postoperative hysterectomy pain management in patients who underwent hysterectomy. METHODS: In this randomized double-blind clinical trial, 60 patients aged 18-85 years with ASA I and II who were candidates for hysterectomy were randomly assigned to two group of 30 patients taking duloxetine (60 mg capsule) or placebo (starch). Opioid use, postoperative pain due to visual analogue score, vital signs and quality of recovery (Recovery-40 form), vital signs before induction of anesthesia, immediately after surgery, at isoflurane induction and after surgery every 15 minutes were reviewed and compared in two groups. FINDINGS: The amount of opioids in the duloxetine group decreased insignificantly. Postoperative pain in recovery and ward in duloxetine group (2.7±0.99 and 1.8±0.66, respectively) compared to placebo group (4.86±1.51 and 4.86±1.51, respectively) decreased significantly (p= 0.006 in recovery and p= 0.001 in ward). The quality of improvement in recovery (156.22±24.25 in the duloxetine group and 125.48±16.49 in the placebo group) was in favor of the effectiveness of duloxetine (p= 0.001). CONCLUSION: In conclusion, DLX is a beneficial drug to be used in multimodal anesthesia strategy especially in improving postoperative pain and quality of recovery in abdominal hysterectomy.

Keywords

• duloxetine hydrochloride
• postoperative pain
• hysterectomy
• analgesics
• opioid.