Effect of Duloxetine on the Perioperative Anxiety Status and Stress Response Following Total Hip Arthroplasty: A Randomized Controlled Trial.
Bohua Li, Manxue Zhang, Qianhao Li et al.
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In 30 seconds
This double-blind randomized controlled trial evaluated perioperative duloxetine in adults without psychiatric comorbidities undergoing unilateral primary total hip arthroplasty. One hundred patients received duloxetine 60 mg daily or placebo from 2 days before surgery through postoperative day 2. On postoperative day 2, anxiety scores on both the Hamilton and self-rating anxiety scales were significantly lower with duloxetine than placebo (both p < 0.05). The duloxetine group also had lower walking pain and stress-related measures, alongside better recovery scores, hip function, activity scores, and satisfaction.
Key findings
- On postoperative day 2, Hamilton and self-rating anxiety scores were lower with duloxetine than placebo (both p < 0.05).
- Walking pain was lower in the duloxetine group (p < 0.05).
- ESR, NLR, TNF-α, ACTH, plasma cortisol, and blood glucose were lower with duloxetine (all p < 0.05).
- QoR-15, Harris hip, and UCLA activity scores and patient satisfaction were higher with duloxetine (all p < 0.05).
Why it matters
Anxiety and physiological stress may accompany major joint surgery, and this trial suggests a brief perioperative duloxetine course can improve anxiety measures while also reducing walking pain and several stress-related biomarkers. The findings connect psychological outcomes with early recovery measures in patients without diagnosed psychiatric disease, although they do not establish whether biomarker changes mediate the observed clinical differences.
What to keep in mind
The trial assessed outcomes only through postoperative day 2 for the intervention period described, so it does not establish the persistence of benefits beyond the early postoperative period.