Colorectal Cancer Clinical Trial
Official title:
Efficacy of Perioperative Duloxetine as a Part of Multimodal Analgesia in Laparoscopic Colorectal Cancer Surgery
Our aim will be to evaluate the efficacy of perioperative Duloxetine in decreasing acute postoperative pain after laparoscopic colorectal cancer surgery and its role in reducing postoperative morphine requirements
Abdominal surgery is usually associated with severe; wide spread post-operative pain. The
greater propensity for pain and opioid-related side effects are likely contributing factors
for poor postsurgical recovery, and it often results in significant pain and slow recovery.
Although Opioids are considered the analgesics of choice to treat moderate to severe pain,
their use carries the risk of side effects and hyperalgesia. Multimodal analgesia is
advocated for perioperative pain management to reduce opioid use and its associated adverse
effects. Multimodal analgesia can be achieved by combining different analgesics and different
methods of administration, to provide better analgesia synergistically compared with
conventional analgesia.Therefore, lower doses for each drug can be provided with fewer
overall side-effects obtained from individual compounds.Serotonin and norepinephrine are
involved in the modulation of endogenous analgesic mechanisms via descending inhibitory pain
pathways in the brain and spinal cord. An increase in serotonin and norepinephrine may
increase inhibition of nociceptive input and improve pain relief.
Duloxetine is a serotonin-norepinephrine reuptake inhibitor commonly prescribed for the
treatment of major depression and anxiety. Duloxetine also has been used in the treatment of
chronic pain conditions. There several reasons why duloxetine might improve postsurgical
quality of recovery. First, systemic Duloxetine seems to have perioperative analgesic
effects. In addition, as a serotonin-norepinephrine reuptake inhibitor, it is possible that
the drug may prevent transient emotional problems that are common during the perioperative
period. Lastly, the combination of less pain and better emotional status can result in better
physical independence scores after surgery.
The main objective of the current study is to examine the effect of perioperative Duloxetine
on postoperative pain after laparoscopic colorectal surgery.
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