未经批准:度洛西汀是食品和药物管理局批准的治疗抑郁症的选择性去甲肾上腺素再摄取抑制剂,焦虑,纤维肌痛,和神经性和慢性肌肉骨骼疼痛。这项荟萃分析旨在评估度洛西汀在减轻下肢全关节置换术后疼痛和术后阿片类药物使用方面的疗效。
未经批准:进行了文献检索,研究度洛西汀用于全髋关节和全膝关节置换术后疼痛管理的随机对照试验.从视觉模拟量表(VAS)中提取了术后第1、3、7和14天(PODs)以及术后第6周和术后第3个月的运动和休息时疼痛的数据。在24、48和72小时获得阿片类药物使用数据。所有数据均使用具有随机效应的逆方差分析,并以加权平均差表示。
未经评估:确定并纳入了8项独特的研究,其中7份进行了定量分析。度洛西汀在48和72小时减少了术后阿片类药物的消耗。对于静息疼痛的VAS,据报道,接受度洛西汀治疗的患者在POD3,POD7和术后第6周疼痛显著减轻.对于运动疼痛的VAS,据报道,接受度洛西汀治疗的患者在POD1,POD3,POD7,POD14,术后第6周和术后第3个月时疼痛显著减轻.
未经批准:度洛西汀似乎可减少全关节置换术后的术后疼痛和阿片类药物消耗。然而,明确的结论受到样本量小和研究异质性的限制。虽然有必要进行后续研究以确定最佳剂量,持续时间,和患者群体,强有力的初步数据为未来大规模疗效研究提供了有力支持.
UNASSIGNED: Duloxetine is a Food and Drug Administration-approved selective norepinephrine reuptake inhibitor for treating depression, anxiety, fibromyalgia, and neuropathic and chronic musculoskeletal pain. This meta-analysis aims to evaluate the efficacy of duloxetine in reducing pain and postoperative opioid use following lower extremity total joint arthroplasty.
UNASSIGNED: A literature search was performed, identifying randomized controlled trials investigating duloxetine for pain management after total hip and total knee arthroplasty. Data from the visual analog scale (VAS) for pain during movement and at rest were extracted for postoperative days (PODs) 1, 3, 7, and 14, as well as postoperative week 6 and postoperative month 3. Opioid use data were obtained at 24, 48 and 72 hours. All data were analyzed using inverse variance with random effects and presented as weighted mean difference.
UNASSIGNED: Eight unique studies were identified and included, 7 of which were analyzed quantitatively. Duloxetine decreased postoperative opioid consumption at 48 and 72 hours. For VAS for pain at rest, significantly reduced pain was reported by duloxetine-treated patients at POD 3, POD 7, and postoperative week 6. For VAS for pain at movement, significantly reduced pain was reported by duloxetine-treated patients at POD1, POD 3, POD 7, POD 14, postoperative week 6, and postoperative month 3.
UNASSIGNED: Duloxetine appears to decrease postoperative pain and opioid consumption following total joint arthroplasty. However, definitive conclusions are limited by small sample size and study heterogeneity. While there is a need for follow-up studies to determine the optimal dose, duration, and patient population, strong preliminary data provide robust support for future large-scale efficacy studies.