The effects of a short-term perioperative duloxetine treatment on post-colectomy pain: A randomized, controlled clinical trial

Study objective: To test the hypothesis that duloxetine reduces postoperative morphine consumption and pain intensity in patients undergoing major colonic surgeries. Design: Single-center, prospective, double-blinded, randomized, controlled trial. Setting: Tertiary university hospital, from December 2019 to September 2021. Patients: Sixty 18-85 years old, ASA I - III patients undergoing elective open major colonic surgeries were randomly allocated into duloxetine (duloxetine) or placebo (placebo) groups (n = 30 per group). Interventions: Duloxetine 60 mg or placebo was administered orally 2 h before and 24 h after surgery. Measurements: PCA morphine consumption, surgical pain at rest, and movement measured on 10-cm visual analog scales (VAS), Ramsay sedation scores, and the incidence of adverse effects potentially associated with duloxetine were assessed at patients' admission to the post-anesthesia care unit (PACU), 6, 24, and 48 h post-operatively (PO). Main results: After adjusting for age, BMI, ASA physical status, education level, and incision type, no differences were found between groups in PCA morphine consumption 24 PO h (duloxetine = 5.44 +/- 2.06 mg; placebo = 10.33 +/- 2.06 mg, p = 0.62) or 48 h PO (duloxetine = 9.18 +/- 2.06 mg, placebo = 12.93 +/- 2.06, p = 1). Pain at rest also did not differ between groups at 24 h PO (duloxetine = 1.76 +/- 0.67 cm; placebo = 1 +/- 0.67 cm, p = 1) or at 48 h PO (duloxetine = 0.84 +/- 0.67 cm; placebo = 0.49 +/- 0.67 cm, p = 1). Similarly, groups did not differ regarding pain on movement at 24 h PO (duloxetine = 2.09 +/- 0.68 cm; placebo = 1.80 +/- 0.68, p = 1) or at 48 h PO (duloxetine = 1.16 +/- 0.68 cm; placebo = 0.88 +/- 0.68 cm, p = 1). Sedation scores and adverse effects also did not differ between groups. Conclusion: Under this study's conditions, short-term duloxetine did not reduce total opioid consumption or pain intensity during the initial 48 h following major colon surgery.

Automated summary

Short-term use of duloxetine does not reduce opioid consumption or pain intensity during the initial 48 hours following major colon surgery.