Objective: The use of drugs with different mechanisms, in combination for the treatment of pain, particularly acute postoperative pain, is a main part of the multimodal analgesia. The aim of this study was to evaluate the ef cacy of metamizol plus paracetamol and compare it with the association of paracetamol plus dexketoprofen in acute postoperative pain. Methods: We designed a prospective interventional study that included 42 patients undergoing general anesthesia for probably low algesic and duration of surgery < 120 minutes. All were treated with one grame of intraoperative paracetamol and then, in the resuscitation unit, when the score on the simple numeric scale was > 3, they received the drug of the group that they were assigned (metamizol: group M; dexketoprofen: group D), with evaluation of variations in the scale score. We examined in both groups demographic variables, variables related to anesthesia and surgery, simple numeric scale (NSE) changes, complications and the incidents during the process. Results: 20 patients were studied in the M group and 22 patients in D group. Both groups had a similar distribution in terms of demographic variables, medical history, type and duration of surgery. Both group showed a clinically relevant decrease in the score of the simple numeric scale (p < 0.05). No differences were in the decrease of NSE when we compared the two groups together (p > 0.05). Conclusion: Our results suggest that the combination of paracetamol plus metamizol in combined therapy for management of acute postoperative pain is effective and comparable to the combination of paracetamol plus dexketoprofen and can constitute an alternative therapy.