Artigo Produção Nacional Revisado por pares

Duloxetine as an Analgesic Reduces Opioid Consumption After Spine Surgery

2016; Lippincott Williams & Wilkins; Volume: 33; Issue: 10 Linguagem: Inglês

10.1097/ajp.0000000000000471

ISSN

1536-5409

Autores

Antônio Bedin, Rafael Antonio Caldart Bedin, Joaquim Edson Vieira, Hazem Adel Ashmawi,

Tópico(s)

Musculoskeletal pain and rehabilitation

Resumo

Multimodal analgesia is widely advocated for the control of perioperative pain in an effort to reduce the use of opioid. Duloxetine is a selective inhibitor of serotonin and norepinephrine reuptake with efficacy for chronic pain conditions. The primary objective of this study was to evaluate the efficacy of two 60 mg oral doses of duloxetine in terms of fentanyl consumption during the postoperative period in patients undergoing elective spine surgery.This study was prospective, double-blind, randomized, and placebo controlled. Patients received either 60 mg duloxetine or an identical placebo 1 hour before surgery and again the following morning. The study participants were allocated into 2 groups: Group C (control) participants received the placebo and Group D (duloxetine) participants received 60 mg duloxetine. The total consumption of fentanyl 48 hours after surgery was measured. Secondary end points were pain scores and the presence or absence of adverse effects, such as headache, nausea, vomiting, itching, dizziness, and drowsiness.Demographic characteristics did not differ between groups. There was a significant difference in fentanyl consumption in the first 24 hours between Groups C and D (mean difference, 223.11±39.32 µg; P<0.001). Fentanyl consumption also differed between Groups C and D after 48 hours (mean difference, 179.35±32.55 µg; P<0.000). The pain scores over 48 hours did not significantly differ between groups. The incidence of side-effects was similar in both groups.Duloxetine was effective as an adjunct for postoperative analgesia and reduced opioid consumption.

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