Comparison of duloxetine and pregabalin for post-operative analgesia in abdominal gynecological surgery under spinal anaesthesia

Background: Post-operative pain still remains a major issue even with modern surgical techniques. Opioids and non-steroidal anti-inflammatory drugs cause many side effects so clinicians try to use opioid-sparing drugs. Pregabalin and duloxetine are already used in routine practice for post-operative pain. This study was done to compare their effect on pain scores and analgesic use in abdominal gynecological surgeries. Aims and Objectives: The aim of the study was to observe and compare post-operative pain scores, rescue analgesia use, patient satisfaction and adverse effects in patients receiving duloxetine or pregabalin as part of routine perioperative analgesia. Materials and Methods: This was a prospective observational comparative study conducted at Medical College on 100 female patients aged 25–65 years undergoing abdominal gynecological surgeries. Patients who received either oral pregabalin 75 mg or oral duloxetine 30 mg as per the treating anesthesiologist’s routine practice were included. Pain was assessed using Numeric Rating Scale (NRS) at rest and during movement at fixed intervals. Rescue tramadol use, sedation and side effects were recorded. Data were analyzed using SPSS 25, P<0.05 taken significant. Results: Baseline demographics were similar. Mean NRS scores were lower in the duloxetine group at 6, 12, 18 and 24 h showing better late pain relief. Rescue analgesia requirement was similar in both groups. Satisfaction scores were also comparable. Side effects such as nausea, dizziness and somnolence were mild and did not differ significantly. Conclusion: Both drugs offered good post-operative analgesia with a stable safety profile. Duloxetine showed comparatively better pain control in the later post-operative period, while overall analgesic consumption remained similar.