Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy – A systematic review
Background and Aims: Patients undergoing hysterectomy by open or laparoscopic approach experience moderate to severe postoperative pain. A multimodal analgesic approach is recommended for these patients. This study reviews the analgesic efficacy of duloxetine, a selective serotonin and norepinephrin...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2023;volume=67;issue=9;spage=770;epage=777;aulast=Nair |
| _version_ | 1797649345917485056 |
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| author | Abhijit Nair Manish Thakre Manamohan Rangaiah Ujjwalraj Dudhedia Nitinkumar Borkar |
| author_facet | Abhijit Nair Manish Thakre Manamohan Rangaiah Ujjwalraj Dudhedia Nitinkumar Borkar |
| author_sort | Abhijit Nair |
| collection | DOAJ |
| description | Background and Aims: Patients undergoing hysterectomy by open or laparoscopic approach experience moderate to severe postoperative pain. A multimodal analgesic approach is recommended for these patients. This study reviews the analgesic efficacy of duloxetine, a selective serotonin and norepinephrine reuptake inhibitor used as an adjuvant for opioid-sparing postoperative analgesia. Methods: After registering the protocol in the international prospective register of systematic reviews (PROSPERO), databases like PubMed, Ovid, Scopus, Cochrane Library and clinicaltrials.gov were searched for randomised controlled trials using relevant keywords to find studies in which duloxetine premedication was compared to a placebo in patients undergoing hysterectomy. The revised Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess the quality of evidence. Results: The qualitative systematic review included five of the 88 studies identified. The overall risk of bias in the included studies was very high. In all the studies, 60 mg oral duloxetine was used, and the control group was placebo. In two studies, duloxetine premedication was administered 2 h before and 24 h after surgery. In the other three studies, a single dose of 60 mg duloxetine was only administered 2 h before surgery. A pooled meta-analysis was not performed due to fewer studies that fulfilled the inclusion criteria and even fewer studies with consistent reporting of various outcomes. Conclusion: The evidence is insufficient to advocate routine duloxetine premedication in patients undergoing hysterectomy. |
| first_indexed | 2024-03-11T15:45:49Z |
| format | Article |
| id | doaj.art-25224f4e1db749c29d3a1c95a5680b4f |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-03-11T15:45:49Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-25224f4e1db749c29d3a1c95a5680b4f2023-10-26T06:31:05ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172023-01-0167977077710.4103/ija.ija_170_23Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy – A systematic reviewAbhijit NairManish ThakreManamohan RangaiahUjjwalraj DudhediaNitinkumar BorkarBackground and Aims: Patients undergoing hysterectomy by open or laparoscopic approach experience moderate to severe postoperative pain. A multimodal analgesic approach is recommended for these patients. This study reviews the analgesic efficacy of duloxetine, a selective serotonin and norepinephrine reuptake inhibitor used as an adjuvant for opioid-sparing postoperative analgesia. Methods: After registering the protocol in the international prospective register of systematic reviews (PROSPERO), databases like PubMed, Ovid, Scopus, Cochrane Library and clinicaltrials.gov were searched for randomised controlled trials using relevant keywords to find studies in which duloxetine premedication was compared to a placebo in patients undergoing hysterectomy. The revised Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess the quality of evidence. Results: The qualitative systematic review included five of the 88 studies identified. The overall risk of bias in the included studies was very high. In all the studies, 60 mg oral duloxetine was used, and the control group was placebo. In two studies, duloxetine premedication was administered 2 h before and 24 h after surgery. In the other three studies, a single dose of 60 mg duloxetine was only administered 2 h before surgery. A pooled meta-analysis was not performed due to fewer studies that fulfilled the inclusion criteria and even fewer studies with consistent reporting of various outcomes. Conclusion: The evidence is insufficient to advocate routine duloxetine premedication in patients undergoing hysterectomy.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2023;volume=67;issue=9;spage=770;epage=777;aulast=Nairacute painanalgesiapremedicationduloxetinesurgeryhysterectomyquality of recoverylength of hospital staysystematic reviewmeta-analysis |
| spellingShingle | Abhijit Nair Manish Thakre Manamohan Rangaiah Ujjwalraj Dudhedia Nitinkumar Borkar Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy – A systematic review Indian Journal of Anaesthesia acute pain analgesia premedication duloxetine surgery hysterectomy quality of recovery length of hospital stay systematic review meta-analysis |
| title | Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy – A systematic review |
| title_full | Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy – A systematic review |
| title_fullStr | Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy – A systematic review |
| title_full_unstemmed | Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy – A systematic review |
| title_short | Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy – A systematic review |
| title_sort | analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy a systematic review |
| topic | acute pain analgesia premedication duloxetine surgery hysterectomy quality of recovery length of hospital stay systematic review meta-analysis |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2023;volume=67;issue=9;spage=770;epage=777;aulast=Nair |
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