Efficacy of Duloxetine for Postspine Surgery Pain: A Systematic Review and Meta-Analysis

IF 2.6 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior Pub Date : 2024-12-31 DOI:10.1002/brb3.70217

Abdulsalam Mohammed Aleid, Faisal Alshehri, Naif Alasiri, Fatimah Alhomoud, Shouq Alsaegh, Mohammed Alrasheed, Salem Aljaddua, Ali Alasiri, Asma Boukhari, Abdulmonem Ali Alhussain, Bipin Chaurasia, Saud Nayef Aldanyowi

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引用次数: 0

Abstract

Background

Duloxetine, a serotonin and norepinephrine reuptake inhibitor (SNRI), is used to treat various health conditions, including major depressive disorder, generalized anxiety disorder, fibromyalgia, and off-label for chemotherapy-induced pain. We conducted this systematic review and meta-analysis aiming to test the current evidence regarding effectiveness and safety of duloxetine for postspine surgeries pain.

Methods

We searched the Cochrane Central Register of Controlled Trials, PubMed, Scopus and Web of science databases for relevant articles up to March 2024. The following search terms were Used in combination using the Boolean operators ((Duloxetine Hydrochloride) AND ((Pain, Postoperative) OR (Postoperative Period) OR (Postoperative Cognitive Complications) OR (Delayed Emergence from Anesthesia) OR (Postoperative Care) OR (spine surgery)) without time constrain for the search. Meta-analysis was performed using Review Manager (RevMan version 5.4) on the extracted outcome data that present in at least 3 of the included studies. Mean difference (MD) was used as the effect size for continuous outcomes with a 95% confidence interval (CI) or standardized mean difference (SMD) in case of different outcome reporting scales.

Results

Pooled analysis showed that duloxetine significantly reduces pain intensity after 24 h from the operation compared to placebo (SMD = −1.11, 95% CI [−2.16 to −0.07], p = 0.04) with no significant difference in pain after 2 and 48 h. Meta-analysis revealed that duloxetine shows a significant reduction in the amount of analgesic consumption after 24 h postoperative; (MD = −3.33, 95% CI [−5.53 to −1.13], p = 0.003). The analysis did not show any statistically significant difference between duloxetine and placebo in patients experiencing nausea or vomiting (RR = 1.37, 95% CI [0.62 to 3.00]

Conclusion

The findings of this study suggest that duloxetine may be effective in reducing pain 24 h after spine surgery. Furthermore, there is a promising effect of duloxetine in treating chronic postoperative pain. However, it is important to acknowledge that further research is warranted to thoroughly evaluate the efficacy and safety of duloxetine for relieving chronic postoperative pain.

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度洛西汀治疗脊柱术后疼痛的疗效：一项系统综述和荟萃分析。

背景：度洛西汀是一种血清素和去甲肾上腺素再摄取抑制剂（SNRI），用于治疗各种健康状况，包括重度抑郁症、广泛性焦虑症、纤维肌痛和化疗引起的非适应症疼痛。我们进行了这项系统回顾和荟萃分析，旨在检验目前关于度洛西汀治疗脊柱术后疼痛的有效性和安全性的证据。方法：检索Cochrane Central Register of Controlled Trials、PubMed、Scopus和Web of science数据库，检索截止到2024年3月的相关文章。以下搜索词使用布尔运算符(（盐酸度洛西汀）和（（疼痛，术后）或（术后期间）或（术后认知并发症）或（麻醉延迟苏醒）或（术后护理）或（脊柱手术））组合使用，不受搜索时间限制。使用Review Manager （RevMan version 5.4）对至少3项纳入研究中提取的结果数据进行meta分析。在不同结果报告量表的情况下，使用平均差（MD）作为连续结果的效应量，95%置信区间（CI）或标准化平均差（SMD）。结果：合并分析显示，与安慰剂相比，度洛西汀可显著降低术后24 h疼痛强度（SMD = -1.11, 95% CI [-2.16 ~ -0.07], p = 0.04），术后2 h和48 h疼痛无显著差异。meta分析显示，度洛西汀可显著降低术后24 h镇痛药的用量；(MD = -3.33, 95% CI [-5.53 - -1.13], p = 0.003)。分析未显示度洛西汀与安慰剂在恶心或呕吐患者中的差异有统计学意义（RR = 1.37, 95% CI[0.62 ~ 3.00]）。结论：本研究结果提示度洛西汀可有效减轻脊柱手术后24小时疼痛。此外，度洛西汀在治疗慢性术后疼痛方面也有很好的效果。然而，重要的是要认识到，需要进一步的研究来彻底评估度洛西汀缓解术后慢性疼痛的有效性和安全性。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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