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Original Article

The Korean Journal of Pain 2020; 33(1): 40-47

Published online January 1, 2020 https://doi.org/10.3344/kjp.2020.33.1.40

Copyright © The Korean Pain Society.

Perioperative duloxetine as part of a multimodal analgesia regime reduces postoperative pain in lumbar canal stenosis surgery: a randomized, triple blind, and placebo-controlled trial

Nishith Govil1 , Kumar Parag2 , Pankaj Arora3 , Hariom Khandelwal2 , Ashutosh Singh2 , and Ruchi4

1Department of Anaesthesiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
2Department of Anaesthesiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, India
3Department of Neurosurgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, India
4Department of Community Medicine, Government Doon Medical College, Dehradun, India

Correspondence to:Nishith Govil
Department of Anaesthesiology, All India Institute of Medical Sciences Rishikesh, Virbhadra Road Near Barrage, Shivaji Nagar, Sturida Colony, Rishikesh 249203, India
Tel: +91-0135-2752946
Fax: +91-0135-0161340
E-mail: nishithgovil@rediffmail.com

Received: June 4, 2019; Revised: August 19, 2019; Accepted: August 26, 2019

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Duloxetine is an antidepressant that is also useful in chronic neuropathic and central origin pain. In this study, the role of duloxetine in decreasing acute postoperative pain after lumbar canal stenosis surgery is explored.

Methods

In this single center, triple blinded, and placebo-controlled trial, 96 patients were randomized for statistical analysis. The intervention group received oral duloxetine 30 mg once a day (OD) for 2 days before surgery, 60 mg OD from the day of surgery to the postoperative second day and 30 mg OD for the next 2 days (a total duration of 7 days). A placebo capsule was given in the other group for a similar time and schedule. The same standard perioperative analgesia protocols were followed in both groups.

Results

Total morphine consumption up to 24 hours was significantly decreased in the duloxetine group (P < 0.01). The time to the first analgesia requirement was similar in both groups but the time to the second and third dose of rescue analgesia increased significantly in the duloxetine group. The time to ambulation was decreased significantly (P < 0.01) in the duloxetine group as compared to the placebo group. Pain scores remained similar during most of the time interval. No significant difference was observed in the complication rate and patient satisfaction score recorded.

Conclusions

Duloxetine reduces postoperative pain after lumbar canal stenosis surgery with no increase in adverse effects.

Keywords: Acute Pain, Analgesia, Antidepressive Agents, Duloxetine Hydrochloride, Humans, Morphine, Pain Management, Pain, Postoperative, Patient Satisfaction, Walking