Clinical study evaluating the perioperative combination of duloxetine and pregabalin to improve postoperative pain after mega-liposuction surgery under general anesthesia: a double-blind randomized clinical trial

Background: Patients undergoing liposuction often experience moderate-to-severe postoperative pain, delaying recovery and reducing patient satisfaction. This study evaluated the effectiveness and safety of combined duloxetine and pregabalin in reducing postoperative pain and opioid consumption after mega-liposuction surgery.Methods: This randomized controlled trial included 90 patients aged 18–50 years with American Society of Anesthesiologists physical status I–II, scheduled for elective mega-liposuction under general anesthesia. Patients were randomized into three groups (30 in each). Group I received pregabalin 300 mg plus duloxetine 60 mg orally 90 min preoperatively, followed by pregabalin 75 mg 12 hourly and duloxetine 60 mg once daily for three postoperative days. Group II received pregabalin plus placebo on the same schedule, whereas Group III received placebo capsules only.Results: Postoperative morphine consumption over 72 h was lower in Group I (19.40 ± 2.51 mg) than in Groups II and III (24.07 ± 3.14 mg vs. 33.90 ± 4.74 mg). Time to the first analgesic request was longer in Group I (2.39 ± 0.72 h) than in Groups II and III (1.89 ± 0.61 h vs. 0.95 ± 0.52 h; P < 0.001). Group I demonstrated higher postoperative global Quality of Recovery Questionnaire-40 (183.10 ± 4.85) and satisfaction scores (3.47 ± 0.68) than Group II (181.10 ± 4.50, 2.90 ± 0.76) and Group III (178.57 ± 5.51, 2.23 ± 0.97) (P = 0.003 and P < 0.001, respectively).Conclusions: Perioperative duloxetine combined with pregabalin improved postoperative pain, reduced morphine consumption, and enhanced recovery quality after mega-liposuction without substantial adverse effects.