Prophylactic Role of Amitriptyline after Major Lower Limb Fractures and in Orthopedic Surgeries in Preventing Post Operative Depression

Abstract

BACKGROUND: Fractures of the long bones of the lower limb, which commonly occur suddenly, are known to cause a temporary decline in quality of life due to physical limitations. This acute occurrence has economic repercussions and also makes patients dependent on others for fundamental day-to-day requirements, causing them to feel insecure and depressed. The suffering is relatively long lasting at least 3 months, the pain persists till then. This chronic pain can be depressing, may result in long term sequalae. One of the most damaging difficulties and major health concerns in the orthopaedics area is postoperative depression after serious lower limb fractures and orthopaedic surgery. Due to the limitations of clinical investigations of amitriptyline as an antidepressant in lowering post-operative depression in patients with lower limb fractures, our study provide an insight on potential role of amitriptyline as antidepressant. The goal of this study was to assess the prophylatic role of amitriptyline in avoiding post-operative depression in orthopaedic patients following significant lower limb fractures and in orthopaedic procedures. METHODS: This was a recent prospective observational study conducted over a 6-month period in the orthopaedics department of a Super Specialty hospital. The patient's information was gathered via the case sheets and a history interview. Continuous variables were represented using the mean, median, and standard error of the mean (SEM). Categorical variables were represented using frequencies and percentages. RESULTS: Based on the inclusion criteria, 60 people were chosen for this study. Age and gender did not significantly differ between the two study groups. There is a statistically significant difference between the research groups in the percentage of improvement of the Numerical Pain Rating Scale (NPRS) pain score and the Hamilton Depression Rating Scale (HDRS) depression score. CONCLUSION: Our study revealed that individuals receiving amitriptyline immediately after surgery had shown better efficacy in reducing Pain and depression when compared to pre surgery. The Pain score before surgery was found to be higher when compared to after surgery. Depression score shows that 70% patients is normal after 6 weeks of surgery. Amitriptyline served as an excellent antidepressant’s inpatients of lower limb fractures with improvement in the pain and depression score post-surgery.