Abstract

Duloxetine is a dual reuptake inhibitor of norepinephrine and serotonin. Serotonin or 5-hydroxytryptamine acts by affecting a wide range of receptors, including the 5-HT2A receptor, which plays a role in modulating neuropathic or inflammatory pain. This systematic review was aimed to consider the effect of duloxetine on reducing the pain in patients undergoing arthroplasty surgery. Articles with key words "Pain, Duloxetine, Postoperative pain, Total knee arthroplasty, Arthroplasty" were searched in four international databases PubMed, Scopus, Science Direct, and Web of Science. Nine articles which fulfilled the inclusion/exclusion criteria were selected of which 3 were conducted in China, 3 in Korea, 1 in Netherlands, and 2 in the USA. In three studies duloxetine was used in a dose of 30 mg, while in all other studies 60 mg was used. In all reviewed articles (except for the two), duloxetine reduced the pain of total knee arthroplasty patients. It is therefore recommended to prescribe this drug to reduce the pain in these patients, while recommending more studies in this field.