Objective: The aim was to evaluate the effect of oral administration of preoperative duloxetine on postoperative pain and total analgesic requirement in the postoperative period as the primary objective. The secondary objective was to evaluate the perioperative hemodynamic parameters, sedation scores, demographic data, and incidence of side effects (if any) in patients undergoing laparoscopic cholecystectomy. Materials and Methods: This was a prospective, randomized, double-blind, placebo-controlled study conducted in a tertiary level medical college on 60 patients of either sex posted for laparoscopic cholecystectomies with American Society of Anesthesiologists (ASA) I and II. The patients were divided into 2 groups (n=30), the patients were given duloxetine 60 mg capsules and placebo capsules (Becosules) 2 hours before surgery. Results: The total requirement for both first and second rescue analgesics was higher in placebo as compared with duloxetine and was found to be significant (P<0.05). The difference in mean visual analog scale score was significantly (P<0.001) higher in placebo as compared with duloxetine at all-time intervals postoperatively 0 minute (7.6±0.7 vs. 4.6±0.8); 15 minutes (5.9±0.8 vs. 4.2±1.0); 30 minutes (4.4±0.5 vs. 3.6±0.9); 4 hours (6.6±0.06 vs. 5.3±1.3); 8 hours (5.2±1.2 vs. 3.9±1.0); and 12 hours (5.1±1.3 vs. 2.3±0.7). The mean arterial blood pressure and heart rate were significantly higher in placebo compared with duloxetine in most of the time intervals in the perioperative period. There was no significant difference in the sedation score between the groups except the 30 minutes and 8 hours postoperative. Discussion: Preoperative oral duloxetine during laparoscopic cholecystectomy could reduce postoperative pain, postoperative analgesic requirements, and better optimization of hemodynamics without causing major side effects.

Background: Spinal anesthesia is used in wide range of surgical procedures, but it is associated with potential complications such as hypotension and shivering. Thus the present study was aimed to compare the effect of 6mg ondansetron and placebo 10 minutes before spinal anesthesia for prevention of hypotension and shivering in patients undergoing non-obstetric surgeries. Methods: A double blinded randomized placebo control trial was conducted in 50 patients. Patients were randomized into ondansetron group (n =25) and placebo group (n=25).The primary outcome was the measurement of SBP(Systolic Blood Pressure), DBP(Diastolic Blood Pressure), MAP(Mean Arterial Pressure) and HR(Heart Rate) at baseline, 5, 10, 15 and 30 minutes after subarachnoid block. Results: There was a significant mean difference in SBP and DBP at 5, 10, 15 and 30 minutes after subarachnoid block (SAB) between the groups (p<0.05). Further, significant decreased MAP was observed at 5,10,15 and 30 minutes after SAB in placebo as compared to ondansetron group (p<0.05). Further 30 minutes after SAB, 28% of patients in placebo group and 4% of patients in ondansetron group had shivering (p=0.04). Conclusion: The present study shows that ondansetron is a suitable agent for the mitigation of spinal anesthesia-induced hypotension and shivering during non-obstetric surgeries.