A Prospective Study to Compare the Perioperative Oral Duloxetine and Gabapentin for Postoperative Quality of Recovery in Female Patients Undergoing Lower Abdominal Gynecological Surgeries

Bansal, Sachin; Dabla, Laveena; Bhatia, Kiran; Becki, Anon; Aiysha, Anon

doi:10.37506/v11/i2/2020/ijphrd/194929

Cited by 2 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…31,36 Background analgesia included acetaminophen alone, 33,40,49,51 or in combination with NSAIDs (celecoxib 36 or metamizole 52 ), opioids (codeine, 30,34 tramadol, 38,42,45,48 fentanyl, 48,50 or oxycodone 45 ), or both, 31,39 and NSAIDs 37,41,43,47 or opioids (morphine or pentazocine) 29 alone. Four trials 32,35,44,46 did not report baseline analgesia. Opioids (morphine, fentanyl, 41,45 tramadol, 46 and pethidine 43,51 ) were used as rescue analgesia in 15 trials 30,34,36e38,40,41,43e48,50,51 ; combination of acetaminophen and opioids was used in two trials 33,39 and diclofenac in one trial 42 ; six trials 29,31,32,35,49,52 did not report rescue analgesia.…”

Section: Study Characteristicsmentioning

confidence: 96%

“…Four trials 32,35,44,46 did not report baseline analgesia. Opioids (morphine, fentanyl, 41,45 tramadol, 46 and pethidine 43,51 ) were used as rescue analgesia in 15 trials 30,34,36e38,40,41,43e48,50,51 ; combination of acetaminophen and opioids was used in two trials 33,39 and diclofenac in one trial 42 ; six trials 29,31,32,35,49,52 did not report rescue analgesia.…”

Section: Study Characteristicsmentioning

confidence: 96%

“…50 Placebo was the most common control (23 trials with 25 comparisons), including two four-arm trials that compared placebo with etoricoxib, 40 morphine or pentazocine 29 as baseline treatment. Three trials compared SNRIs with anticonvulsants (including gabapentin 30,46 and pregabalin 42 ), and one four-arm trial compared duloxetine with etoricoxib. 40 The median duration of treatment was 3 days (ranging from one dose pre-surgery to 201 days perioperatively); 13 trials used SSRIs/SNRIs for 3 days or less, 31,37,40e44,46,47,49e52 and 11 trials used SSRIs/SNRIs for 7e201 days.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Three studies with 231 patients compared SNRIs (duloxetine 42,46 and venlafaxine 30 ) with anticonvulsants (gabapentin 30,46 and pregabalin 42 ). Low-quality evidence showed no significant difference between SNRI(s) and anticonvulsants for postoperative pain at 2e4 h (WMD 0.13 cm on a 10 cm VAS; 95% CI: e0.44 to 0.69), 12 h (WMD 0.10 cm; 95% CI: e0.39 to 0.59), 24 h (WMD 0.37 cm; 95% CI: e0.07 to 0.81), 48 h (WMD 0.66 cm; 95% CI: e0.7 to 2.02), 72 h (WMD 0.10 cm; 95% CI: e0.29 to 0.49), 1 week (WMD 0.20 cm; 95% CI: 0.00e0.40), and 10 days (WMD 0.10 cm; 95% CI: e0.08 to 0.28); patient satisfaction (RR 0.73; 95% CI: 0.51e1.05); and PONV (RR 1.59; 95% CI: 0.94e2.69), dizziness (RR 1.99; 95% CI: 0.86e4.62), and headache (RR 3.00; 95% CI: 0.89e10.16) (Supplementary Table 2).…”

Section: Snris Vs Anticonvulsantsmentioning

confidence: 99%

See 3 more Smart Citations

Selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors as adjuncts for postoperative pain management: systematic review and meta-analysis of randomised controlled trials

Wang

Tobe

et al. 2022

British Journal of Anaesthesia

View full text Add to dashboard Cite

Section: Study Characteristicsmentioning

confidence: 96%

Section: Study Characteristicsmentioning

confidence: 96%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Snris Vs Anticonvulsantsmentioning

confidence: 99%

See 2 more Smart Citations

Selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors as adjuncts for postoperative pain management: systematic review and meta-analysis of randomised controlled trials

Wang

Tobe

et al. 2022

British Journal of Anaesthesia

View full text Add to dashboard Cite

“…It is well known that these patients are more prone to severe resistant chronic pain and have already increased baseline pain scores. Two studies have comparators, gabapentin by Bansal et al and pregabalin by Chachra et al 57,58 We omit them from our analysis as, again, these adjuncts have proven analgesic benefits compared to a placebo. Similarly, we retrieved data only from the placebo group arm from three studies where the comparator besides placebo was pregabalin (Altiparmak et al), etoricoxib (Attia et al) and dexamethasone (Kassim et al 26,28,29 ).…”

Section: Description Of Studiesmentioning

confidence: 99%

Postoperative acute pain management with duloxetine as compared to placebo: A systematic review with meta‐analysis of randomized clinical trials

Govil¹,

Arora²,

Parag³

et al. 2023

Pain Practice

View full text Add to dashboard Cite

BackgroundDuloxetine has been used as an adjunct in multimodal analgesia for acute postoperative pain in clinical studies. This meta‐analysis aims to conclude whether oral duloxetine, when given perioperatively, is any better than a placebo in managing postoperative pain. Effects of duloxetine on postoperative pain scores, time to first rescue analgesia, postoperative rescue analgesia consumption, side effects attributable to duloxetine, and patient satisfaction profile were assessed.MethodMEDLINE, Web of Science, EMBASE, Scholar Google, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched with keywords including “Duloxetine” AND “postoperative pain”, “Duloxetine” AND “acute pain” and with “Duloxetine” till October 2022. This meta‐analysis included randomized clinical trials in which perioperative duloxetine 60 mg per oral was administered not more than 7 days before surgery and for at least 24 after surgery but not more than 14 days after surgery. All RCTs in which the comparator is placebo and outcomes related to analgesic efficacy like pain scores, opioid consumption, and side effects of duloxetine until 48 h postoperatively were included. Data were extracted from the studies and a risk of bias summary was formed using the Cochrane Collaboration tool. Effect sizes were given as standardized mean differences for continuous outcomes and risk ratios (RR) by the Mantel–Haenszel test for the categorical outcome. Confirmation of publication bias was done by Egger's regression test (p < 0.05). If publication bias or heterogeneity was detected, the trim‐and‐fill method was used to calculate the adjusted effect size. Sensitivity analysis was done by leaving one out method after excluding the study with a high risk of bias. Subgroup analysis was done based on the type of surgery and gender. The study was prospectively registered in the PROSPERO under the registration number CRD42019139559.Findings29 studies with 2043 patients met the inclusion criteria and were reviewed for this meta‐analysis. Postoperative pain scores at 24 h [Std. Mean Difference (95% CI); −0.69 (−1.07, −0.32)] and at 48 h [−1.13 (−1.68, −0.58)] are significantly less with duloxetine (p‐value < 0.05). Time to first rescue analgesia was significantly more in patients where duloxetine was administered [1.27 (1.10, 1.45); p‐value > 0.05]. Opioid consumption up to 24 h [−1.82 (−2.46, −1.18)] and 48 h [−2.48 (−3.46, −1.50)] was significantly less (p‐value < 0.05) in patients who received duloxetine. Complications and recovery profiles were similar in patients receiving either duloxetine or a placebo.InterpretationBased on GRADE findings, we conclude that there is low to moderate evidence to advocate the use of duloxetine for managing postoperative pain. Further trials are needed to replicate or refute these results based on robust methodology.

show abstract

A Prospective Study to Compare the Perioperative Oral Duloxetine and Gabapentin for Postoperative Quality of Recovery in Female Patients Undergoing Lower Abdominal Gynecological Surgeries

Cited by 2 publications

References 0 publications

Selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors as adjuncts for postoperative pain management: systematic review and meta-analysis of randomised controlled trials

Selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors as adjuncts for postoperative pain management: systematic review and meta-analysis of randomised controlled trials

Postoperative acute pain management with duloxetine as compared to placebo: A systematic review with meta‐analysis of randomized clinical trials

Contact Info

Product

Resources

About