Duloxetine for Acute Postoperative Pain Management in Patients Undergoing Orthopedic Surgery: A Meta-analysis of Randomized Controlled Trials .

Duloxetine continues to draw interest as part of multimodal analgesia after orthopedic surgery, and the latest RCT evidence helps clarify where it may fit. Across nine trials—most published in the past decade and focused on arthroplasty or lumbar spine procedures—adding duloxetine consistently reduced acute postoperative pain at 24, 48, and 72 hours. It also lowered opioid use at early postoperative time points, an appealing finding given concerns around opioid-related harms. Safety signals were reassuring, with no differences in nausea, dizziness, headache, or somnolence. Effects weren’t seen in the first few hours after surgery, and evidence quality ranged from moderate to low, but together the data suggest duloxetine can play a helpful, well-tolerated role in early postoperative pain control.