"Preoperative oral duloxetine: does it affect duration of spinal anesthesia and early postoperative pain after arthroscopic ACL repair?" A prospective, randomized, double-blind controlled trial

Background: Postoperative pain is one of the problems in which a lack of adequate controls can cause many complications. Duloxetine is a potent serotonin and norepinephrine reuptake inhibitor (SNRI) prescribed for the treatment of depression, chronic pain, neuropathy, and recently early postoperative pain. Results: The results showed that the effect of duloxetine on the onset and duration of the spinal anesthesia was statistically non-significant (P = 0.067 and P = 0.21) respectively; also, duloxetine delayed the time to the first dose of rescue analgesia request (479.71 +/- 50.32 vs 218.29 +/- 12.48) (P < 0.001) and maintained VAS score in the lower range in comparison to control group (P = 0.001) with less frequency and total morphine consumption (4.2 +/- 2.08 vs 10.37 +/- 1.52) (P < 0.001) up to 24 h. No significant differences in adverse effects. Conclusions: A single dose of 60mg duloxetine orally 2 h before arthroscopic ACL repair provided better postoperative pain control and decreased total morphine consumption without affecting the duration of spinal anesthesia.