“Preoperative oral duloxetine: does it affect duration of spinal anesthesia and early postoperative pain after arthroscopic ACL repair?” A prospective, randomized, double-blind controlled trial

Abstract

Abstract Background Postoperative pain is one of the problems in which a lack of adequate controls can cause many complications. Duloxetine is a potent serotonin and norepinephrine reuptake inhibitor (SNRI) prescribed for the treatment of depression, chronic pain, neuropathy, and recently early postoperative pain. Results The results showed that the effect of duloxetine on the onset and duration of the spinal anesthesia was statistically non-significant (P = 0.067 and P = 0.21) respectively; also, duloxetine delayed the time to the first dose of rescue analgesia request (479.71 ± 50.32 vs 218.29 ± 12.48) (P < 0.001) and maintained VAS score in the lower range in comparison to control group (P = 0.001) with less frequency and total morphine consumption (4.2 ± 2.08 vs 10.37 ± 1.52) (P < 0.001) up to 24 h. No significant differences in adverse effects. Conclusions A single dose of 60 mg duloxetine orally 2 h before arthroscopic ACL repair provided better postoperative pain control and decreased total morphine consumption without affecting the duration of spinal anesthesia.

Keywords

• Duloxetine
• Serotonin and norepinephrine reuptake inhibitors
• Postoperative pain
• Morphine
• Arthroscopic ACL repair
• Spinal anesthesia