Highlights
- •Duloxetine is a potent selective serotonin norepinephrine reuptake inhibitor.
- •A prospective clinical trial investigated whether duloxetine reduces postoperative knee pain.
- •Duloxetine administration showed good outcomes after high tibial osteotomy.
- •Postoperative non-steroidal anti-inflammatory drug use was significantly reduced.
Abstract
Background
Postoperative pain management is essential for patient satisfaction; however, no reports
have described the effect of perioperative duloxetine administration on the postoperative
pain management following knee surgery. This study aimed to determine whether perioperative
duloxetine administration reduces pain following high tibial osteotomy.
Methods
In this prospective clinical trial, 35 and 33 patients receiving (40 mg/day) and not
receiving duloxetine (control), respectively were enrolled. The knee pain and quality
of recovery were evaluated using the numeric rating scale (NRS) scores, the frequency
of analgesic drugs used, and patient-reported outcome measures, including the NRS
score at rest and the Knee Injury and Osteoarthritis Outcome Score (KOOS), were compared
between the groups.
Results
The NRS scores of the duloxetine group (D) were significantly reduced compared with
those of the control group (C) on postoperative day 1 (D:3.8 vs C:5.1, p = 0.022), day 7 (D:2.1 vs C:2.9, p = 0.021), and day 14 (D:1.6 vs C:2.9, p = 0.001). Non-steroidal anti-inflammatory drug administration was significantly lower
in the duloxetine group than in the control group (p < 0.001). Although the KOOS score was not significantly different in several subcategories
at the pre- and postoperative time-points, the Function in Sport subcategory of the
KOOS was significantly improved in the duloxetine group compared with that in the
control group at 3 months postoperatively (p < 0.05).
Conclusion
Perioperative use of duloxetine from 2 weeks before surgery to 2 weeks after surgery
is advantageous in perioperative pain management and KOOS improvement following high
tibial osteotomy.
Keywords
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Article info
Publication history
Published online: July 28, 2022
Accepted:
July 15,
2022
Received in revised form:
June 3,
2022
Received:
December 17,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
