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Pain Relieving Potentials of Combination of Oral Duloxetine and Intravenous Magnesium Sulphate in Post Mastectomy Pain

Not Applicable
Completed
Conditions
Duloxetine
Magnesium Sulphate
Post-mastectomy Pain Syndrome
Interventions
Drug: Magnesium sulphate and Duloxetine
Drug: Placebo and normal saline
Registration Number
NCT06087211
Lead Sponsor
National Cancer Institute, Egypt
Brief Summary

This study aims to evaluate the effect of combined duloxetine and IV Magnesium sulphate to decrease acute and chronic post mastectomy pain.

The study will be conducted in National Cancer Institute and all the participants will be enrolled from female patients scheduled for modified radical mastectomy under general anesthesia in National Cancer Institute, Cairo University.

Detailed Description

It has been reported recently that Duloxetine improved the quality of recovery in patients subjected to hysterectomy. In this context, mastectomy has a negative consequence starting from cancer diagnosis to the squeal of cancer-related treatments and it has been estimated that 20%-30% of patients with breast cancer suffer from depression and anxiety. Magnesium also antagonizes the release of inflammatory mediators such as histamine, serotonin, and cytokines in peripheral tissues.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
90
Inclusion Criteria
  • Age from 18 to 65 years old.
  • American Society of Anesthesiologists (ASA) physical I-II
  • Scheduled for modified radical mastectomy (MRM) under general anesthesia.
Exclusion Criteria
  • Liver or kidney disease
  • Patient with previous chronic pain on opioids
  • Patients on antidepressants and antipsychotics.
  • Allergies to study drugs

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DM groupMagnesium sulphate and DuloxetinePatients received Duloxetine 30mg orally and an intravenous infusion of magnesium sulphate 50mg/kg mixed with 200 ml of normal saline.
D groupDuloxetinePatients received Duloxetine 30mg orally and 200 ml of normal saline.
Control groupPlacebo and normal salinePatients received a placebo capsule and an intravenous infusion of 200 mL of normal saline
Primary Outcome Measures
NameTimeMethod
Time to first analgesic request48 hours postoperatively

Time to the first request for the rescue analgesia (time from end of surgery to first dose of morphine administared).

Secondary Outcome Measures
NameTimeMethod
Degree of pain48 hours postoperatively

Each patient was instructed about postoperative pain assessment with the Visual Analogue Scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at post-anesthesia care unit (PACU), 1, 2, 4, 6, 8, 12, 24, 36 and 48 h postoperatively.

Incidence of post-mastectomy pain syndrome12 weeks postoperatively

Incidence of post-mastectomy pain syndrome was determined at 8- and 12-weeks post-mastectomy.

Degree of patient satisfaction48 hours postoperatively

The degree of patient satisfaction was assessed on a 5-point Likert scale (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied).

Incidence of adverse eventsat 8 weeks postoperative and 12 weeks postoperative

Incidence of adverse events such as bradycardia, hypotension, postoperative nausea and vomiting (PONV) were recorded.

Total morphine consumption48 hours postoperatively

Postoperative analgesia is composed of PCA-morphine, set to deliver 2 mg boluses on-demand without background infusion with a lockout period of 10 min and regular intravenous paracetamol, one gram every 8 h.

Trial Locations

Locations (1)

National cancer institute

🇪🇬

Cairo, Egypt

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