Status:

COMPLETED

Effect of Duloxetine on Opioid Use After Total Knee Arthroplasty

Lead Sponsor:

Hospital for Special Surgery, New York

Conditions:

Joint Disease

Pain, Acute

Eligibility:

All Genders

25-75 years

Phase:

PHASE4

Brief Summary

Post-discharge pain after total knee arthroplasty remains problematic; many patients have excessive pain at the 2 week time point (and often thereafter). Reduction in opioid use has become a national ...

Eligibility Criteria

Inclusion

  • Age 25 to 75 years
  • Planned use of regional anesthesia
  • Ability to follow study protocol
  • English speaking (Primary outcome obtained via telephone call and secondary outcomes include questionnaires validated in English only)
  • Patients planning on being discharged home or to a rehabilitation center that has agreed to participate

Exclusion

  • Current Use of duloxetine or other SNRIs, SSRIs, MAOIs, Tricyclic antidepressants, triptans (sumatriptan, rizatriptan, naratriptan, eletriptan, almotriptan, frovatriptan), lithium, buspirone, St. John's Wort
  • Hepatic insufficiency
  • o Hepatoxicity is reported as a side effect of duloxetine. "Median time to detection of transaminase elevation was about two months" (package insert 5.2
  • Renal insufficiency (ESRD, HD, estimated creatinine clearance \< 50 ml/min)
  • Severe CRI may impair duloxetine clearance
  • CLcr=\[(140-age (years)\] x weight (kg)x0.85 (for female patients)/\[72xserum creatinine (mg/dL)\]
  • Patients younger than 25 years old and older than 75
  • Patients intending to receive general anesthesia
  • Allergy or intolerance to one of the study medications
  • Patients with an ASA of IV
  • Chronic gabapentin/pregabalin use (regular use for longer than 3 months)
  • Patients with major prior ipsilateral open knee surgery.
  • Chronic opioid use (taking opioids for longer than 3 months)
  • However, patients using chronic opioids may enroll in a parallel pilot study entitled 'effect of duloxetine on opioid use after total knee athroplasty among patients exposed to opioids- a pilot study'. The chronic opioid users will be allowed to continue their customary analgesics. The pilot study is otherwise identical to the main study.
  • This study will enroll up to 15 chronic opioid users. After that, all chronic opioid users are excluded.

Key Trial Info

Start Date :

September 28 2017

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

February 19 2021

Estimated Enrollment :

160 Patients enrolled

Trial Details

Trial ID

NCT03271151

Start Date

September 28 2017

End Date

February 19 2021

Last Update

December 27 2024

Active Locations (1)

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1

Hospital for Special Surgery

New York, New York, United States, 10021