Pregabalin Versus Duloxetine on Postoperative Analgesic Requirement Following Lower Extremity Trauma Surgeries: A randomised, Clinical Trial

OBJECTIVE: The use of pregabalin versus duloxetine in postoperative lower limb traumatic pain has not been compared. The aim of this study was to evaluate the response rate of rescue analgesic requirement with perioperative pregabalin versus duloxetine in lower limb trauma surgeries. METHODS: In this randomised, clinical trial, 60 patients of American Society of Anesthesiologists physical status I-II undergoing lower limb trauma surgery were randomised to receive oral pregabalin 150 mg day(-1) or duloxetine 60 mg day(-1), 2 hours prior to surgery and then once daily for next 2 days postoperatively. The surgery was performed under standardised spinal anaesthesia technique. The investigator was blinded to the study drug, oral paracetamol 1 g every 6 hours and intravenous diclofenac 75 mg was a rescue analgesic. The primary outcome of the study was response rate in terms of rescue analgesia requirement. Secondary outcomes included total rescue analgesia, visual analogue scale at rest and on movement, haemodynamics, anxiety depression score, and patient satisfaction score and adverse effects. RESULTS: In group pregabalin, 60% of patients required the first dose of rescue analgesia versus 50% in group duloxetine for 72 hours postoperatively. In group pregabalin, 6.6% of patients required the second dose of rescue analgesia after a mean duration of 24 hours, and 10% of patients in group duloxetine required the second dose after a mean duration of 40 hours. The visual analogue scale scores, time to first rescue, and cumulative rescue analgesic were comparable in both the groups. CONCLUSION: Equivalent rate-responsive rescue analgesia was required in patients receiving pregabalin or duloxetine following lower limb trauma surgery.