Analgesic effect of perioperative escitalopram in high pain catastrophizing patients after total knee arthroplasty: a randomized, double-blind, placebo-controlled trial

Anesthesiology
T H LunnH Kehlet

Abstract

Sufficient pain treatment remains a challenge after total knee arthroplasty (TKA), especially in high pain catastrophizing patients. Serotonergic signaling may be involved in pain processing, but the effect of selective serotonin reuptake inhibitors on well-defined postoperative pain has not previously been investigated. The authors hypothesized that perioperative escitalopram would reduce pain after TKA in high pain catastrophizing patients. A total of 120 pain catastrophizing patients (selected using the pain catastrophizing scale as preoperative screening tool) scheduled for TKA were randomized in a double-blind manner to either 10 mg escitalopram or placebo daily from preanesthesia to postoperative day 6 in addition to a standardized analgesic regime. The primary outcome was pain upon ambulation 24 h after surgery. Secondary outcomes were overall pain during well-defined mobilizations and at rest from 2 to 48 h and from days 2 to 6, morphine equivalents, anxiety, depression, and side effects. Pain upon ambulation (mean [95% CI]) 24 h after surgery in the escitalopram versus placebo group was 58 (53 to 64) versus 64 (58 to 69), the mean difference being -5 (-13 to 3), P = 0.20. Overall pain upon ambulation and at rest from d...Continue Reading

References

Jun 1, 1983·Acta Psychiatrica Scandinavica·A S Zigmond, R P Snaith
May 16, 1998·BMJ : British Medical Journal·T V Perneger
Aug 5, 1999·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·P Blier, C de Montigny
Oct 16, 1999·European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology·D J NuttS Argyropoulos
May 30, 2002·Progress in Neurobiology·Mark J Millan
Feb 8, 2006·Biological Psychiatry·Catherine J HarmerGuy M Goodwin
Jan 30, 2007·Journal of Psychopharmacology·M BrowningC J Harmer
May 9, 2008·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Kristin L BigosAhmad R Hariri
Jul 25, 2008·Annals of Surgery·Henrik Kehlet, Douglas W Wilmore
May 6, 2009·Anaesthesia·L Ø AndersenH Kehlet
May 30, 2009·The British Journal of Psychiatry : the Journal of Mental Science·Susannah E MurphyCatherine J Harmer
Jul 9, 2009·Clinical Orthopaedics and Related Research·Daniel L RiddleXiangrong Kong
Aug 29, 2009·Pain Research & Management : the Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur·Robert R EdwardsJeffrey N Katz
Dec 17, 2009·Anesthesiology·Paul F White, Henrik Kehlet
Sep 14, 2010·American Journal of Surgery·Reenam S KhanThanos Athanasiou
Apr 6, 2011·Acta Anaesthesiologica Scandinavica·Henrik Kehlet, L Ø Andersen
Nov 10, 2011·Acta Orthopaedica·Henrik HustedHenrik Kehlet
Feb 15, 2012·The Clinical Journal of Pain·Tone BlågestadJanne Grønli
Mar 9, 2012·Lancet·Andrew J CarrDavid J Beard
Jun 22, 2012·Psychological Medicine·B R GodlewskaC J Harmer
Jul 27, 2012·British Journal of Anaesthesia·L KrenkH Kehlet
Jan 29, 2013·The International Journal of Neuropsychopharmacology·Magdalena NordLars Farde
Apr 2, 2013·The Journal of Pain : Official Journal of the American Pain Society·Patrícia R PintoVera Araújo-Soares
Apr 2, 2013·The Journal of Arthroplasty·Lene KrenkHenrik Kehlet
Apr 10, 2013·The Annals of Thoracic Surgery·Sidney ChocronJoseph-Philippe Etievent
May 24, 2013·JAMA Internal Medicine·Andrew D AuerbachPeter K Lindenauer
Nov 10, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Irina GrosuEmmanuel Thienpont

❮ Previous
Next ❯

Citations

Dec 29, 2015·Acta Anaesthesiologica Scandinavica·E K AasvangH Kehlet
Jun 21, 2017·EFORT Open Reviews·Torben Bæk Hansen
Jan 31, 2018·Drugs·Arnaud Steyaert, Patricia Lavand'homme
Feb 14, 2019·Der Orthopäde·U NöthL Rackwitz
Feb 6, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Faraj W AbdallahColin J L McCartney
Jun 14, 2020·Acta Anaesthesiologica Scandinavica·Niklas I NielsenNicolai B Foss
Apr 2, 2018·Pain Reports·Ian GilronHenrik Kehlet
May 17, 2017·Acta Anaesthesiologica Scandinavica·I E LunaE K Aasvang
Oct 12, 2018·Journal of Experimental Orthopaedics·Thomas BandholmHenrik Kehlet
Jan 23, 2016·The Journal of Bone and Joint Surgery. American Volume·Gwo-Chin Lee
Mar 3, 2021·The Journal of Arthroplasty·Yale A FillinghamDavid S Jevsevar

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.