Lee Hyer1, Ciera Scott2, Christine M Mullen1, Laura C McKenzie1, Joe Sam Robinson3. 1. Georgia Neurosurgical Institute, Macon, Georgia; Clinical Medical Psychology, Mercer University School of Medicine, Macon, Georgia. 2. Georgia Neurosurgical Institute, Macon, Georgia; Clinical Mental Health Counseling, Mercer University, Macon, Georgia. 3. Georgia Neurosurgical Institute, Macon, Georgia.
Abstract
OBJECTIVE: This study describes a single-site investigation on the effects of a randomized double-blind placebo trial targeting duloxetine added to opioid use (duloxetine + opioid) against a comparator (placebo + opioid) in spine surgery patients, independent of major depression. DESIGN: The double-blind comparator study assessed two groups on opioids: one using duloxetine and the other a placebo. Subjects were administered the respective medication 2 weeks prior to surgery and continued on this for more than 3 months. Subjects were assessed at three times: prior to surgery, 4 weeks postsurgery, and 12 weeks postsurgery. They completed a battery of tests assessing for pain, adjustment, and psychiatric problems. SETTING: Neurosurgical outpatient and inpatient setting. PATIENTS: Sixty-eight patients completed the study. They received one of three types of elective spine surgery. INTERVENTIONS: Subjects were given duloxetine or placebo 2 weeks prior to surgery and continued with the regimen for more than 3 months. OUTCOMES: The primary focus was pain and second on adjustment factors and psychiatric symptoms: depression and anxiety. The amount of opioid use presurgery and postsurgery was also evaluated. RESULTS: There were differences among the groups on Brief Pain Inventory (BPI)-Average, the core pain marker, and BPI-Sleep. Within-subject analyses showed that duloxetine subjects improved significantly from baseline. For function, post-CIBIC and post-Functional Adjustment Questionnaire were significant, favoring duloxetine. Reduction of opioid use was not a factor; both groups' utilization declined. For affect, both groups were significantly improved over time. CONCLUSIONS:Duloxetine seems to improve pain, assist with maintaining function, and reduce intensity of affect.
RCT Entities:
OBJECTIVE: This study describes a single-site investigation on the effects of a randomized double-blind placebo trial targeting duloxetine added to opioid use (duloxetine + opioid) against a comparator (placebo + opioid) in spine surgery patients, independent of major depression. DESIGN: The double-blind comparator study assessed two groups on opioids: one using duloxetine and the other a placebo. Subjects were administered the respective medication 2 weeks prior to surgery and continued on this for more than 3 months. Subjects were assessed at three times: prior to surgery, 4 weeks postsurgery, and 12 weeks postsurgery. They completed a battery of tests assessing for pain, adjustment, and psychiatric problems. SETTING: Neurosurgical outpatient and inpatient setting. PATIENTS: Sixty-eight patients completed the study. They received one of three types of elective spine surgery. INTERVENTIONS: Subjects were given duloxetine or placebo 2 weeks prior to surgery and continued with the regimen for more than 3 months. OUTCOMES: The primary focus was pain and second on adjustment factors and psychiatric symptoms: depression and anxiety. The amount of opioid use presurgery and postsurgery was also evaluated. RESULTS: There were differences among the groups on Brief Pain Inventory (BPI)-Average, the core pain marker, and BPI-Sleep. Within-subject analyses showed that duloxetine subjects improved significantly from baseline. For function, post-CIBIC and post-Functional Adjustment Questionnaire were significant, favoring duloxetine. Reduction of opioid use was not a factor; both groups' utilization declined. For affect, both groups were significantly improved over time. CONCLUSIONS:Duloxetine seems to improve pain, assist with maintaining function, and reduce intensity of affect.
Authors: C Côté; M Bérubé; L Moore; F Lauzier; L Tremblay; E Belzile; M-O Martel; G Pagé; Y Beaulieu; A M Pinard; K Perreault; C Sirois; S Grzelak; A F Turgeon Journal: BMC Musculoskelet Disord Date: 2022-03-11 Impact factor: 2.362