Rajamohan Sharmila, Chikkapillappa Manjunath Abloodu, Rath Prapti, Pujari Vinayak Seenappa, Anandaswamy Tejesh C, Rajappa Geetha C
Department of Anaesthesia, Ganga Medical Centre and Hospitals, Coimbatore, Tamil Nadu, India.
Department of Anaesthesia, MS Ramaiah Medical College, Bengaluru, Karnataka, India.
Anesth Essays Res. 2021 Jan-Mar;15(1):107-110. doi: 10.4103/aer.aer_47_21. Epub 2021 Aug 30.
Women undergoing hysterectomy present a unique set of challenges to the anesthesiologist in terms of postoperative pain management. This study was conducted to see the effect of single-dose perioperative duloxetine 60 mg on postoperative analgesia following abdominal hysterectomy under spinal anesthesia.
This prospective randomized placebo-controlled study was conducted on 64 patients scheduled to undergo elective abdominal hysterectomy under spinal anesthesia. The patients were divided into two groups of 32 in each, Group D received duloxetine 60 mg 2 h preoperatively and Group P received placebo 2 h preoperatively. Postoperatively, the patients were evaluated by an independent observer for pain on rest and during cough at 0 (arrival at postanesthesia care unit), 2, 4, 6, 12, and 24 h. In addition, the postoperative analgesic requirements and adverse effects were noted.
Independent -test/Mann-Whitney U-test was used to compare the pain score between two groups.
The demographic data were comparable between both the groups. The mean Visual Analogue Scale scores assessed postoperatively at rest and during cough which were not statistically significant between the two groups. The rescue analgesic consumption in Group D (0.97 ± 0.86) and Group P (1.25 ± 0.76) was comparable and statistically not significant. The total analgesic requirement between duloxetine (4.94 ± 0.84) and placebo (1.25 ± 0.76) group was comparable and statistically not significant. The incidence of nausea vomiting and somnolence was higher in Group D.
We conclude that patients receiving a single dose of 60 mg duloxetine as premedication before hysterectomy under spinal anesthesia are no better than placebo on postoperative pain during the first 24 h.
接受子宫切除术的女性在术后疼痛管理方面给麻醉医生带来了一系列独特的挑战。本研究旨在观察围手术期单次给予60毫克度洛西汀对脊髓麻醉下腹部子宫切除术后镇痛的效果。
本前瞻性随机安慰剂对照研究对64例计划在脊髓麻醉下接受择期腹部子宫切除术的患者进行。患者分为两组，每组32例，D组在术前2小时接受60毫克度洛西汀，P组在术前2小时接受安慰剂。术后，由独立观察者在0（到达麻醉后护理单元）、2、4、6、12和24小时评估患者休息时和咳嗽时的疼痛情况。此外，记录术后镇痛需求和不良反应。
采用独立样本t检验/曼-惠特尼U检验比较两组之间的疼痛评分。
两组的人口统计学数据具有可比性。术后休息时和咳嗽时评估的平均视觉模拟量表评分在两组之间无统计学差异。D组（0.97±0.86）和P组（1.25±0.76）的补救性镇痛药物消耗量具有可比性，且无统计学差异。度洛西汀组（4.94±0.84）和安慰剂组（1.25±0.76）之间的总镇痛需求具有可比性，且无统计学差异。D组恶心呕吐和嗜睡的发生率较高。
我们得出结论，在脊髓麻醉下子宫切除术前接受单剂量60毫克度洛西汀作为术前用药的患者，在术后24小时内的疼痛控制方面并不优于安慰剂。
