Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy - A systematic review

被引:3
作者
Nair, Abhijit [1 ]
Thakre, Manish [2 ]
Rangaiah, Manamohan [3 ]
Dudhedia, Ujjwalraj [4 ]
Borkar, Nitinkumar [5 ]
机构
[1] Minist Hlth Oman, Ibra Hosp, Dept Anaesthesiol, POB 275, Ibra 414, Oman
[2] Govt Med Coll, Dept Psychiat, Nagpur, Maharashtra, India
[3] Walsall Manor Hosp, Dept Anaesthet & Pain Management, Moat Rd, Walsall WS2 9PS, W Midlands, England
[4] DR LH Hiranandani Hosp, Dept Anaesthesiol & Pain Management, Powai Mumbai, Maharashtra, India
[5] All India Inst Med Sci, Dept Pediat Surg, Raipur, Chhattisgarh, India
关键词
Acute pain; analgesia; premedication; duloxetine; surgery; hysterectomy; quality of recovery; length of hospital stay; systematic review; meta-analysis; POSTOPERATIVE PAIN; MANAGEMENT; SURGERY; BLIND;
D O I
10.4103/ija.ija_170_23
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
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.
引用
收藏
页码:770 / +
页数:9
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