Evaluation of two different dose regimens of preoperative Duloxetine on Postoperative Pain After laparoscopic cholecystectomy: Randomized Controlled Trial

This study is a prospective randomized double blind trial involving 122 patients undergoing elective cholecystectomy under general anesthesia Patients are randomly divided into two groups of 61 each using a computer generated sequence with allocation concealed in sealed envelopes opened by a pharmacist not involved in the study

Group A receives duloxetine 30 mg the night before surgery and 30 mg two hours before surgery Group B receives 30 mg the night before and 60 mg two hours before surgery Both are given with small amounts of water

All patients receive standard premedication with ondansetron midazolam and glycopyrrolate Standard monitoring is applied and anesthesia is induced with fentanyl propofol and vecuronium followed by endotracheal intubation and mechanical ventilation using oxygen nitrous oxide and isoflurane Hemodynamic parameters are recorded at regular intervals after induction

At the end of surgery residual carbon dioxide is removed and neuromuscular blockade is reversed No additional intraoperative analgesics are given Duration of surgery is recorded

Postoperatively patients are monitored in the recovery unit Pain is assessed using the visual analogue scale at 2 4 8 12 and 24 hours and shoulder pain is assessed using a numeric rating scale Rescue analgesia with intravenous acetaminophen is given if pain score is 4 or more

All data including drug doses clinical parameters and patient responses are recorded for analysis