Perioperative Duloxetine and Etoricoxibto improve postoperative pain after lumbar Laminectomy: A randomized, double-blind, controlled study

Abstract

Background: Duloxetine, Etoricoxib and opioid are of the commonly administered drugs in Lumbar laminectomy. The aim of this study is to assess the effect of perioperative use of Duloxetine in combination with Etoricoxib on postoperative pain and opioid requirements. Methods: One hundred twenty patients with ASA physical status were enrolled with age between 18 and 70years. Patients were divided randomly into four groups of 30 patients: group P received placebo, group E received etoricoxib 120mg, group D received duloxetine 60mg and group D/E received duloxetine 60mg capsules and etoricoxib 120mg; 1 h before surgery and 24h after. Results: Neither Duloxetine nor etoricoxib individually had effect on pain with movement, while their combination revealed a significant reduction in pain scores over the entire postoperative period at rest and on movement. Etoricoxib showed a significant decrease in pain at all times at rest when compared with group P, while it showed significant pain decrease only at 0, 2 and 4h when compared with group D. On the other hand duloxetine alone showed significant decrease in pain at rest at 24h and 48h when compared with group P. ConcerningMorphine requirement after 24h.; it wassignificantly lower in the D/E group in comparison with groups P, E and D. It should be noted also that there was a significant decrease morphine requirement in both groups E and D. Conclusion: The perioperative administration of the combination of etoricoxib and duloxetine improved analgesia and reduced opioid consumption without significant side effects. Trial registration:ISRCTN48329522. 17 June 2017