Duloxetine for postoperative pain management in total hip and knee arthroplasty: a systematic review and meta-analysis.
Abdelrahman Ibrahim, Mohamed Abdelnabi, Reda Ali Sheta
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy of perioperative duloxetine for pain management in patients undergoing total hip and knee arthroplasties. In 13 randomized controlled trials involving 1176 patients, duloxetine significantly reduced pain at rest (MD -5.09 mm) and during ambulation (MD -4.55 mm) at 24 hours post-surgery, with opioid-sparing effects observed at 48 and 72 hours.
Key findings
- Duloxetine reduced pain at rest by MD -5.09 mm at 24 hours (P = 0.006).
- Significant opioid-sparing effect at 48 hours with MD -22.74 MME (P = 0.04).
- Duloxetine decreased the risk of nausea/vomiting (RR 0.73, P = 0.03).
- Increased risk of drowsiness/somnolence (RR 1.88, P = 0.001).
Why it matters
Effective pain management post-surgery is crucial to minimize opioid dependence and enhance recovery. This study suggests that duloxetine may be a beneficial adjunct in multimodal analgesia for patients undergoing hip and knee arthroplasties.
What to keep in mind
Findings are subject to substantial heterogeneity, and some results lost significance upon sensitivity analysis.