Significant Analgesic Benefits of Perioperative Duloxetine in Patients Who Have Depressive Symptoms Undergoing Total Hip Arthroplasty: A Randomized Controlled Trial

被引:8
作者
Ding, Zi-chuan [1 ]
Li, Hao [1 ,2 ]
Huang, Chao [1 ]
Yuan, Ming-cheng [1 ]
Cao, Jian [1 ]
Wang, Hao-yang [1 ,3 ]
Zhou, Zong-ke [1 ,3 ]
机构
[1] Sichuan Univ, West China Hosp, West China Sch Med, Dept Orthoped, Chengdu, Peoples R China
[2] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Joint Surg, Guangzhou, Peoples R China
[3] Sichuan Univ, West China Hosp, West China Sch Med, Dept Orthoped, 37 Wuhou Guoxue Rd, Chengdu, Peoples R China
关键词
total hip arthroplasty; depressive symptoms; duloxetine; postoperative analgesia; randomized controlled trial; KNEE ARTHROPLASTY; PAIN; ANXIETY; MODULATION; EFFICACY;
D O I
10.1016/j.arth.2022.10.007
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Major symptoms of depression are commonly observed in patients requiring total hip arthroplasty (THA), and this is associated with increased pain scores and opioid consumption. We aimed to investigate the analgesic effect of duloxetine in these high-risk patients.Methods: Among 263 patients scheduled for primary unilateral THA, 67 patients who scored at least 8 on the 17-item Hamilton Depression Scale (HAMD) were enrolled in this study. Patients were randomized to the duloxetine group (60 mg daily, from the day of surgery to postoperative day 6) or the placebo group. The postoperative visual analog scale (VAS) score during walking, the VAS score during hip flexion, and resting VAS score was measured. Postoperative morphine consumption, hip range of motion (ROM), Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function, postoperative length of stay (LOS), and adverse events were recorded.Results: The duloxetine group had significantly lower VAS scores during walking and hip flexion from postoperative day 3 to week 3 than the placebo group. With regard to the resting VAS score, duloxetine showed a better analgesic effect from postoperative day 3 to week 2 than placebo. Patients in the duloxetine group had less consumption of morphine. The duloxetine group exhibited better hip function scores, including ROM, HHS, and WOMAC function scores than the placebo group. No significant dif-ference was observed in LOS or adverse events between groups.Conclusion: Perioperative short-term duloxetine provides advantages in decreasing pain, reducing morphine consumption, and increasing hip function in THA patients who have depressive symptoms.(c) 2022 Published by Elsevier Inc.
引用
收藏
页码:519 / 524
页数:6
相关论文
共 38 条
[11]   Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale [J].
Farrar, JT ;
Young, JP ;
LaMoreaux, L ;
Werth, JL ;
Poole, RM .
PAIN, 2001, 94 (02) :149-158
[12]   Should Depression Be Treated Before Lower Extremity Arthroplasty? [J].
Fehring, Thomas K. ;
Odum, Susan M. ;
Curtin, Brian M. ;
Mason, John B. ;
Fehring, Keith A. ;
Springer, Bryan D. .
JOURNAL OF ARTHROPLASTY, 2018, 33 (10) :3143-3146
[13]   A Randomized Controlled Trial of Psychological Intervention to Improve Satisfaction for Patients with Depression Undergoing TKA A 2-Year Follow-up [J].
Geng, Xiao ;
Wang, Xinguang ;
Zhou, Ge ;
Li, Feng ;
Li, Yang ;
Zhao, Minwei ;
Chu, Hongling ;
Li, Jitao ;
Si, Tianmei ;
Liu, Zhongjun ;
Tian, Hua .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2021, 103 (07) :567-574
[14]   Is duloxetine's effect on painful physical symptoms in depression an indirect result of improvement of depressive symptoms? Pooled analyses of three randomized controlled trials [J].
Harada, Eiji ;
Tokuoka, Hirofumi ;
Fujikoshi, Shinji ;
Funai, Jumpei ;
Wohlreich, Madelaine M. ;
Ossipov, Michael H. ;
Iwata, Nakao .
PAIN, 2016, 157 (03) :577-584
[15]   Postoperative pain treatment after total hip arthroplasty: a systematic review [J].
Karlsen, Anders Peder Hojer ;
Geisler, Anja ;
Petersen, Pernille Lykke ;
Mathiesen, Ole ;
Dahl, Jorgen B. .
PAIN, 2015, 156 (01) :8-30
[16]   The Impact of Psychological Factors and Their Treatment on the Results of Total Knee Arthroplasty [J].
Kazarian, Gregory S. ;
Anthony, Christopher A. ;
Lawrie, Charles M. ;
Barrack, Robert L. .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2021, 103 (18) :1744-1756
[17]   Preemptive Duloxetine Relieves Postoperative Pain and Lowers Wound Temperature in Centrally Sensitized Patients Undergoing Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial [J].
Kim, Man Soo ;
Koh, In Jun ;
Sung, Yong Gyu ;
Park, Dong Chul ;
Na, Jae Won ;
In, Yong .
JOURNAL OF CLINICAL MEDICINE, 2021, 10 (13)
[18]   Treated Versus Untreated Depression in Total Joint Arthroplasty Impacts Outcomes [J].
Kohring, Jessica M. ;
Erickson, Jill A. ;
Anderson, Mike B. ;
Gililland, Jeremy M. ;
Peters, Christopher L. ;
Pelt, Christopher E. .
JOURNAL OF ARTHROPLASTY, 2018, 33 (07) :S81-S85
[19]   Duloxetine reduces pain after Total hip arthroplasty: a prospective, randomized controlled study [J].
Li, Hao ;
Zeng, Wei-Nan ;
Ding, Zi-Chuan ;
Yuan, Ming-Cheng ;
Cai, Yong-Rui ;
Zhou, Zong-Ke .
BMC MUSCULOSKELETAL DISORDERS, 2021, 22 (01)
[20]   Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia [J].
Lunn, Michael P. T. ;
Hughes, Richard A. C. ;
Wiffen, Philip J. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2014, (01)