European Journal of Cardiovascular Medicine

Background- The induction of hyperalgesia is a well-documented consequence of surgical trauma, and inadequate pain management has been identified as a contributing factor to the development of persistent pain during the postoperative phase. The primary objectives of this study were to assess and compare the impact of pregabalin and duloxetine on post-operative pain scores. Methods: In this observational study, a total of 120 patients with American Society of Anesthesiologists physical status I-II who were scheduled for lower limb trauma surgery were randomly assigned to two groups. One group received oral pregabalin at a dosage of 150 mg per day, while the other group received duloxetine at a dosage of 60 mg per day. The medications were administered 2 hours prior to surgery and continued once daily for the following 2 days after the surgery. The surgical procedure was conducted utilizing a standardized technique for spinal anesthesia. The investigator was unaware of the treatment allocation, which consisted of oral paracetamol at a dosage of 1 g every 6 hours, and intravenous diclofenac at a dosage of 75 mg as a rescue analgesic. The main objective of the study was to assess the response rate in relation to the need for rescue analgesia. The secondary outcomes encompassed various measures, such as the total amount of rescue analgesia administered, the visual analogue scale scores obtained at rest and during movement, the assessment of haemodynamics, the evaluation of anxiety and depression levels, the assessment of patient satisfaction, and the monitoring of any adverse effects. Results: In the pregabalin group, 60% of patients necessitated the initial administration of rescue analgesia within the first 72 hours following the surgical procedure, while the corresponding figure in the duloxetine group was 50%. Within the pregabalin group, it was observed that 6.6% of patients necessitated a second dose of rescue analgesia, with an average duration of 24 hours. Conversely, in the duloxetine group, 10% of patients required a second dose after an average duration of 40 hours. The scores on the visual analogue scale, the time until the first rescue intervention, and the cumulative use of rescue analgesics were found to be similar in both groups. Conclusion: Equivalent rate-responsive rescue analgesia was required in patients receiving pregabalin or duloxetine following lower limb trauma surgery.