SEROTONIN NOREPINEPHRINE REUPTAKE INHIBITORS IN MANAGING NEUROPATHIC PAIN FOLLOWING SPINAL AND NON-SPINAL SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Rizaldy Taslim Pinzon (2024) SEROTONIN NOREPINEPHRINE REUPTAKE INHIBITORS IN MANAGING NEUROPATHIC PAIN FOLLOWING SPINAL AND NON-SPINAL SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. Clinical Neurology and Neurosurgery Journal, 239. ISSN 0303-8467

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Official URL: https://doi.org/10.1016/j.clineuro.2024.108223

Abstract

Background While serotonin norepinephrine reuptake inhibitors (SNRIs) offer promise in managing Post-surgical neuropathic pain (PSNP), uncertainties remain. This study aims to evaluate the effectiveness and adverse events of SNRIs in managing PSNP. Methods Systematic searches of PubMed, Embase, and Cochrane databases up to January 1st 2023 identified randomized controlled trials (RCTs) comparing SNRIs to placebo for PSNP. The primary outcome measures were pain at rest and adverse events post-surgery. Subgroup analyses were conducted based on surgical type and specific SNRIs. Results A total of 19 RCTs, encompassing 1440 participants (719 in the SNRI group vs 721 in the placebo group), met the inclusion criteria and were included. The pooled results demonstrated that pain scores were significantly lower in patients treated with SNRIs at 2 hours (MD:-0.26; 95%CI: −0.47 to −0.04; p=0.02), 6 hours (MD:-0.68; 95%CI: −1.01 to −0.34; p<0.0001), 24 hours (MD:-0.54; 95%CI: −0.99 to −0.09; p=0.02), and 48 hours (MD:-0.66; 95%CI: −1.23 to −0.10; p=0.02) post-surgery. In terms of adverse events, dizziness (OR:2.53; 95%CI: 1.34–4.78; p=0.004) and dry mouth (OR:2.21; 95%CI: 1.25–3.92; p=0.007) were significantly higher in the SNRIs group. Subgroup analysis showed that SNRI was found to significantly lower the 24-hour pain score after spinal surgery (MD:-0.45; 95%CI: −0.84 to −0.05; p=0.03). Duloxetine (MD:-0.63; 95%CI: −1.15 to −0.11; p=0.02) had a significant effect in lowering the 24-hour pain score at rest compared to placebo, whereas venlafaxine did not. Conclusions SNRIs yielded considerable pain score reductions across multiple post-surgical intervals, although accompanied by an increased incidence of dizziness and dry mouth.

Item Type:	Article
Uncontrolled Keywords:	Complications; Neuropathic pain; Postoperative pain; Serotonin and noradrenaline reuptake; inhibitors
Subjects:	R Kedokteran. Medis > Kedokteran (Umum) R Kedokteran. Medis > Terapi. Farmakologi
Divisions:	Fakultas Kedokteran
Depositing User:	Beatrix Stefany
Date Deposited:	26 Sep 2024 03:14
Last Modified:	26 Sep 2024 03:14
URI:	http://katalog.ukdw.ac.id/id/eprint/9451

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