1
|
Nair A, Thakre M, Rangaiah M, Dudhedia U, Borkar N. Analgesic efficacy and safety of duloxetine premedication in patients undergoing hysterectomy - A systematic review. Indian J Anaesth 2023; 67:770-777. [PMID: 37829772 PMCID: PMC10566655 DOI: 10.4103/ija.ija_170_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/25/2023] [Accepted: 07/29/2023] [Indexed: 10/14/2023] Open
Abstract
Background and Aims Patients undergoing hysterectomy by open or laparoscopic approach experience moderate to severe postoperative pain. A multimodal analgesic approach is recommended for these patients. This study reviews the analgesic efficacy of duloxetine, a selective serotonin and norepinephrine reuptake inhibitor used as an adjuvant for opioid-sparing postoperative analgesia. Methods After registering the protocol in the international prospective register of systematic reviews (PROSPERO), databases like PubMed, Ovid, Scopus, Cochrane Library and clinicaltrials.gov were searched for randomised controlled trials using relevant keywords to find studies in which duloxetine premedication was compared to a placebo in patients undergoing hysterectomy. The revised Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess the quality of evidence. Results The qualitative systematic review included five of the 88 studies identified. The overall risk of bias in the included studies was very high. In all the studies, 60 mg oral duloxetine was used, and the control group was placebo. In two studies, duloxetine premedication was administered 2 h before and 24 h after surgery. In the other three studies, a single dose of 60 mg duloxetine was only administered 2 h before surgery. A pooled meta-analysis was not performed due to fewer studies that fulfilled the inclusion criteria and even fewer studies with consistent reporting of various outcomes. Conclusion The evidence is insufficient to advocate routine duloxetine premedication in patients undergoing hysterectomy.
Collapse
Affiliation(s)
- Abhijit Nair
- Department of Anaesthesiology, Ibra Hospital, Ministry of Health-Oman, Ibra-414, Sultanate of Oman
| | - Manish Thakre
- Department of Psychiatry, Government Medical College, Nagpur, Maharashtra, India
| | - Manamohan Rangaiah
- Department of Anaesthetics and Pain Management, Walsall Manor Hospital, Moat Rd, Walsall WS2 9PS, United Kingdom
| | - Ujjwalraj Dudhedia
- Department of Anaesthesiology and Pain Management, DR. L.H. Hiranandani Hospital, Powai Mumbai, Maharashtra, India
| | - Nitinkumar Borkar
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| |
Collapse
|
3
|
Dreyfus N, Myers JK, Badescu VO, de Frutos O, de la Puente ML, Ding C, Filla SA, Fynboe K, Gernert DL, Heinz BA, Hemrick-Luecke SK, Johnson KW, Johnson MP, López P, Love PL, Martin LJ, Masquelin T, McCoy MJ, Mendiola J, Morrow D, Muhlhauser M, Pascual G, Perun TJ, Pfeifer LA, Phebus LA, Richards SJ, Rincón JA, Seest EP, Shah J, Shaojuan J, Simmons RMA, Stephenson GA, Tromiczak EG, Thompson LK, Walter MW, Weber WW, Zarrinmayeh H, Thomas CE, Joshi E, Iyengar S, Johansson AM. Discovery of a potent, dual serotonin and norepinephrine reuptake inhibitor. ACS Med Chem Lett 2013; 4:560-4. [PMID: 24900709 DOI: 10.1021/ml400049p] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 05/07/2013] [Indexed: 11/30/2022] Open
Abstract
The objective of the described research effort was to identify a novel serotonin and norepinephrine reuptake inhibitor (SNRI) with improved norepinephrine transporter activity and acceptable metabolic stability and exhibiting minimal drug-drug interaction. We describe herein the discovery of a series of 3-substituted pyrrolidines, exemplified by compound 1. Compound 1 is a selective SNRI in vitro and in vivo, has favorable ADME properties, and retains inhibitory activity in the formalin model of pain behavior. Compound 1 thus represents a potential new probe to explore utility of SNRIs in central nervous system disorders, including chronic pain conditions.
Collapse
Affiliation(s)
- Nicolas Dreyfus
- Research and Development, Eli Lilly and Company Ltd., Sunninghill Road, Windlesham,
Surrey GU20 6PH, United Kingdom
| | - Jason K. Myers
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Valentina O. Badescu
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Oscar de Frutos
- Lilly S.A., Centro de Investigación,
Avda. de la Industria, 30, Alcobendas-Madrid
28108, Spain
| | - Maria Luz de la Puente
- Lilly S.A., Centro de Investigación,
Avda. de la Industria, 30, Alcobendas-Madrid
28108, Spain
| | - Chunjin Ding
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Sandra A. Filla
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | | | - Douglas L. Gernert
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Beverly A. Heinz
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Susan K. Hemrick-Luecke
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Kirk W. Johnson
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Michael P. Johnson
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Pilar López
- Lilly S.A., Centro de Investigación,
Avda. de la Industria, 30, Alcobendas-Madrid
28108, Spain
| | | | - Laura J. Martin
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Thierry Masquelin
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Michael J. McCoy
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Javier Mendiola
- Lilly S.A., Centro de Investigación,
Avda. de la Industria, 30, Alcobendas-Madrid
28108, Spain
| | - Denise Morrow
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Mark Muhlhauser
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Gustavo Pascual
- Lilly S.A., Centro de Investigación,
Avda. de la Industria, 30, Alcobendas-Madrid
28108, Spain
| | - Thomas J. Perun
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Lance A. Pfeifer
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Lee A. Phebus
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Simon J. Richards
- Research and Development, Eli Lilly and Company Ltd., Sunninghill Road, Windlesham,
Surrey GU20 6PH, United Kingdom
| | - Juan Antonio Rincón
- Lilly S.A., Centro de Investigación,
Avda. de la Industria, 30, Alcobendas-Madrid
28108, Spain
| | - Eric P. Seest
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Jikesh Shah
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Jia Shaojuan
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Rosa Maria A. Simmons
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Gregory A. Stephenson
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Eric G. Tromiczak
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Linda K. Thompson
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Magnus W. Walter
- Research and Development, Eli Lilly and Company Ltd., Sunninghill Road, Windlesham,
Surrey GU20 6PH, United Kingdom
| | - Wayne W. Weber
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Hamideh Zarrinmayeh
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Craig E. Thomas
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Elizabeth Joshi
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Smriti Iyengar
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| | - Anette M. Johansson
- Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis,
Indiana 46285, United States
| |
Collapse
|