Effect of pregabalin versus duloxetine on analgesic requirement following lower limb trauma surgeries: a randomized, clinical trial

Lower limb trauma comprises a significant portion of trauma surgeries and the most common complaint is pain.The available modalities in multimodal pain management include pharmacological, peripheral nerve blocks and neuraxial analgesia. However, opioids have undesirable side effects like respiratory depression, nausea/vomiting, constipation, sedation and sometimes physical dependence. Opioids also cause gastrointestinal hemorrhage, renal dysfunction and decreased hemostasis. Gabapentinoids is a class of anticonvulsants used in pain management due to good postoperative analgesia, safety profile, better tolerance and fewer drug interactions. Gabapentin and pregabalin are the gabapentioids which are used. Trauma also causes nerve damage which results in posttraumatic neuropathic pain. Thus, neuropathic pain is an element of trauma. Duloxetine is an antidepressant which possesses analgesic effect.There are encouraging results of duloxetine and pregabalin in literature but it is scant in comparison of analgesic efficacy of pregabalin versus duloxetine for postoperative pain relief in trauma patients undergoing lower limb surgeries. We hypothesize that difference exists between response rates in terms of rescue analgesia and postoperative pain relief with the use of either pregabalin or duloxetine. Hence, this trial is planned to compare the response rates of rescue analgesic requirement with perioperative pregabalin or duloxetine in trauma patients undergoing lower limb surgeries.