Duloxetine for Perioperative Pain in Hip Arthroplasty: A RCT

Use of Duloxetine for Perioperative Pain Control After Total Hip Arthroplasty: Randomized Controlled Clinical Trial (RCT)

The primary objective of this study is to compare total narcotic intake standardized via milligram morphine equivalents between duloxetine and placebo cohorts after a total hip arthroplasty.

Inclusion Criteria:

• Patients > 18 years of age
• Patients undergoing primary total hip arthroplasty
• Ambulatory patient prior to fracture
• Subjects must be capable of providing informed consent
• English or Spanish speaking

Exclusion Criteria:

• Previous hemiarthroplasty or THA on ipsilateral hip
• History of Complex Regional Pain Syndrome in ipsilateral extremity
• History of demyelinating disorder or neurologic deficit that may contribute to altered pain tolerance or sensation
• Acute or chronic hip infection in ipsilateral extremity
• Pregnant or breastfeeding
• Open fracture
• Polytrauma
• Intravenous or drug users within 6 months of surgery
• Liver Failure via clinical diagnosis or international normalized ratio greater than 1.5 or partial thromboplastin time greater than 40
• Patients on selective serotonin reuptake inhibitor, serotonin norepinephrine reuptake inhibitor, monoamine oxidase inhibitor, and/or tricyclic anti-depressant
• Severe renal dysfunctions, such as glomerular filtration rate less than 30
• Moderate to severe depression as diagnosed by a clinician
• Taking cytochrome P450 1A2 inhibitors and cytochrome P450 1A6 inhibitors for the duration of 5 half-lives as these drugs are clinically eliminated within 5 half-lives
• History of uncontrolled narrow angle glaucoma