The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou.
The orthopedics hospital of traditional Chinese medicine Zhuzhou city, Hunan.
Int J Surg. 2023 Apr 1;109(4):913-924. doi: 10.1097/JS9.0000000000000230.
The aim was to evaluate the efficacy and safety of duloxetine for postoperative recovery after total knee arthroplasty.
The following electronic databases were searched for eligible trials: PubMed, EMBASE, Web of Science, Cochrane Library, VIP, Wanfang Data, and China National Knowledge Infrastructure (CNKI). The search was performed from the inception dates to 10 August 2022. Data extraction and quality assessment were performed by two independent reviewers. Standard mean differences or mean differences with 95% CIs for pooled data were calculated. The primary outcomes were pain, physical function, and analgesic consumption. Secondary outcomes included range of motion (ROM) of the knee, depression, and mental health.
This meta-analysis included 11 studies, reporting on a total of 1019 patients. Results of analyses indicated that duloxetine showed a statistically significant reduction in pain at rest at 3 days, 1 week, 2, and 6 weeks and pain on movement at 5 days, 1 week, 2, 4, 6, and 8 weeks. However, there was no statistical significance in pain at rest and on movement at 24 h, 12 weeks, 6 months, and 12 months. Additionally, duloxetine had a significant improvement in physical function, ROM of the knee at 6 weeks, and emotional function (depression and mental health). Moreover, the cumulative opioid consumption at 24 h in the duloxetine groups was lower than in the control groups. But there was no statistical significance for the cumulative opioid consumption over 7 days between the duloxetine groups and controls.
In conclusion, duloxetine might reduce pain mainly over a time span of 3 days-8 weeks and lower cumulative opioid consumption within 24 h. In addition, it improved physical function, ROM of the knee with a time span of 1-6 weeks and emotional function (depression and mental health).
评估度洛西汀在全膝关节置换术后康复中的疗效和安全性。
检索了以下电子数据库中的合格试验：PubMed、EMBASE、Web of Science、Cochrane 图书馆、VIP、万方数据和中国知网（CNKI）。搜索从成立日期到 2022 年 8 月 10 日进行。由两名独立评审员进行数据提取和质量评估。计算了合并数据的标准均数差或均数差及 95%置信区间。主要结局指标是疼痛、身体功能和镇痛药物的消耗。次要结局指标包括膝关节活动度（ROM）、抑郁和心理健康。
这项荟萃分析包括 11 项研究，共报告了 1019 名患者。分析结果表明，度洛西汀在 3 天、1 周、2 周和 6 周时的静息疼痛和 5 天、1 周、2 周、4 周、6 周和 8 周时的运动疼痛方面具有统计学意义的降低。然而，在 24 小时、12 周、6 个月和 12 个月时，静息和运动疼痛均无统计学意义。此外，度洛西汀在 6 周时的身体功能、膝关节 ROM 和情绪功能（抑郁和心理健康）方面有显著改善。此外，度洛西汀组的 24 小时累积阿片类药物消耗量低于对照组。但度洛西汀组和对照组在 7 天内的累积阿片类药物消耗量没有统计学意义。
总之，度洛西汀可能主要在 3 天-8 周的时间范围内减轻疼痛，并在 24 小时内降低累积阿片类药物的消耗。此外，它在 1-6 周的时间内改善了身体功能、膝关节 ROM 和情绪功能（抑郁和心理健康）。
