Duloxetine for post-operative analgesia after modified radical mastectomy: A prospective randomized study

Abstract

Background: Insufficient management of postoperative pain has been shown to be correlated with prolonged hospitalization, escalated healthcare expenses, disrupted sleep patterns, heightened risk of depression, compromised functional abilities, and a worse quality of life. The objective of this research is to assess the efficacy of duloxetine in managing postoperative pain following radical mastectomy.Methods: This prospective randomised controlled work was performed on (40) individuals scheduled for modified radical mastectomy in Tanta University Hospital. The criteria for inclusion for this study consisted of adult female patients between the ages of 18 and 60 who were scheduled to have a modified radical mastectomy (MRM), ASA I, II and III. A total of 20 participants were recruited for this research, with an equal number of participants being randomly assigned to each of the two groups. The process of randomization was conducted using a computer-generated method. The patients were allocated by closed envelop into 2 groups: Group (1) (control group): Participants received 500 mg of IV acetaminophen (every 6 hours post operatively). Group (2): Participants received duloxetine 30 mg every 12 h for 3 days prior to operation, 30 mg 2 h prior to surgery and 30 mg 12 h following surgery and 500 mg of IV acetaminophen (every 6 hours following surgery).Results: There was significant decrease at 2,4,6,18,30,36 and 48 h in group 2 contrasted to group 1 (P value <0.001) and statistically insignificant difference in postoperative HR at baseline, PACU, 12, 24 and 42 h among both groups. A substantial decrease in postoperative MAP was existed at 2,4,6,18,30,36 and 48 h in group 2 contrasted to group 1 and statistically insignificant difference at baseline, PACU, 12, 24 and 42 h among both groups (P value <0.001). A statistically substantial decrease in intraoperative fentanyl consumption was existed in group 2 compared to groups 1 (P value <0.001). There was substantial decrease in VAS at 2,4,6,18,30,36 and 48 hours in group 2 contrasted to group 1 (P value<0.05). The satisfied patients in group 2 were significantly higher in group 2 compared to group 1.Conclusions: The current work showed that the use of perioperative duloxetine was safe and effective in controlling pain after modified radical mastectomy.