Cancer Anaesthesia
Conditions
Interventions
Duloxetine
Pregabalin
control
Sponsors
Primary Sponsor
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: o Patients aged 18 – 65 years, and both sexes. o ASA physical status I &? o Scheduled for elective total thyroidectomy
Exclusion criteria
Exclusion criteria: o Patient refusal. o Known allergy or contraindication to study drugs (bupivacaine, duloxetine, pregabalin, fentanyl, morphine). o Coagulopathy or bleeding disorders. o Infection at the site of block. o Pregnancy and lactation. o Chronic pain syndromes or chronic opioid use. o Psychiatric disorders including major depressive disorder, anxiety disorders, or cognitive impairment preventing proper assessment. o Current use of serotonergic medications (SSRIs, SNRIs, MAOIs, triptans) o Cardiovascular disease (uncontrolled hypertension, heart failure). o Glaucoma or Hepatic dysfunction (ALT/AST > 2 times upper limit of normal). o Severe renal dysfunction (CrCl < 30 mL/min) - both drugs require dose adjustment o History of seizures or epilepsy.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time from end of surgery (defined as completion of skin closure) to first request for rescue analgesia (minutes). | — |
Secondary
| Measure | Time frame |
|---|---|
| • VAS pain scores (0-10 scale) at rest at: 1, 2, 4, 6, 8, 12, 24, at rest and on swallowing postoperatively • Peak pain score in first 24 hours • Intraoperative fentanyl consumption (total mcg) • Total morphine consumption in first 24 hours postoperatively (mg) • Number and percentage of patients requiring rescue analgesia • Time to first rescue analgesic request (primary outcome) • Heart rate (beats/minute) • Systolic blood pressure (mmHg) • Diastolic blood pressure (mmHg) • Mean arterial pressure (mmHg) • Recorded at: baseline (preoperative), 1, 2, 4, 6, 8, 12, 24, and 48 hours postoperatively • Time to first ambulation (hours from end of surgery) • Hospital length of stay (days) • Quality of Recovery-15 (QoR-15) score at 24 hours postoperatively (scale 0-150, higher scores indicate better recovery) • Patient satisfaction score at 48 hours (5-point Likert scale: 1 = very dissatisfied , 5 = very satisfied) • Postoperative nausea and vomiting (PONV): incidence and severity using 4-point scale (0 = none, 1 = nausea only, 2 = one episode of vomiting, 3 = multiple episodes) • Sedation: Ramsay Sedation Scale (1-6) at 1, 2, 4, 6, 8, 12, 24, and | — |
Countries
Egypt
Contacts
Public Contactahmed mohasseb mohasseb
Lecturer of Anesthesia
Outcome results
None listed