Clinical equivalence of IV paracetamol compared to IV dipyrone for postoperative analgesia after surgery for breast cancer

Kampe, Sandra; Warm, Mathias; Landwehr, Susanne; Dagtekin, Oguzhan; Haussmann, Sascha; Paul, Matthias; Pilgram, Barbara; Kiencke, P.

doi:10.1185/030079906x132659

Cited by 45 publications

(26 citation statements)

References 14 publications

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“…25 Other studies also did not report any significant difference in time to first request for piritramide and cumulative consumption of piritramide as assessed by the PCA data. 23,35,36 In contrast, several conventional nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors have been shown to reduce opioid requirements and improve analgesia. 37,38 Ng et al found that parecoxib 40 mg IV was associated with significant reductions in 24-hour morphine consumption and pain intensity following abdominal hysterectomy.…”

Section: Discussionmentioning

confidence: 94%

Efficacy of Non-Opioid Analgesics on Opioid Consumption for Postoperative Pain Relief After Abdominal Hysterectomy

Abdulla¹,

Netter²,

Abdulla³

2012

Journal of Gynecologic Surgery

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Objective: The purpose of this study was to compare the analgesic efficacy and pain intensity of and patient's satisfaction with non-opioid analgesics while evaluating postoperative piritramide consumption for providing pain relief after abdominal hysterectomy. Design: This was a randomized, double-blinded study. Materials and Methods: With the patient under general anesthesia, surgery was performed on 120 women using propofol, remifentanil, and muscle relaxant. Four patient groups (n = 30 each) were treated over 24 hours with normal saline (NaCl), parecoxib, metamizol, or paracetamol in addition to piritramide using the patient-controlled analgesia (PCA) pump. Postoperatively, patients were asked every 2 hours for the first 6 hours, and afterwards once every 6 hours, to quantify their pain experience at rest on different pain scales, including patient satisfaction. Cumulative piritramide consumption within 24 hours postoperatively was recorded on the display of the PCA pump. Results: The first required amounts of piritramide in the recovery room were similarly high in all groups and the incremental piritramide consumptions after 6, 12 and 24 hours showed no significant difference among the four groups. Also, with cumulative PCA-piritramide consumption no significant difference could be found. In all groups, the highest level of the visual analogue scale (VAS) score was registered upon arrival in the recovery room. However, there was a significant difference only at 6 hours after surgery between the NaCl group and the paracetamol and parecoxib groups. Conclusions: Compared with placebo, there was no significant difference in regard to opioid-sparing effect by administering additional non-opioids, whereas VAS scores were significantly lower in the paracetamol and parecoxib groups at 6 hours after surgery. Any further benefits were marginal and statistically not significant. ( J GYNECOL SURG 28:101)

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Section: Discussionmentioning

confidence: 94%

Efficacy of Non-Opioid Analgesics on Opioid Consumption for Postoperative Pain Relief After Abdominal Hysterectomy

Abdulla¹,

Netter²,

Abdulla³

2012

Journal of Gynecologic Surgery

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“…Morphine also reduced pain behaviours in a rat model of incisional pain when administered pre-or postsurgically via the intrathecal, subcutaneous or intraperitoneal route Pogatzki et al, 2002;Zahn et al, 1997). In addition, acetaminophen and dipyrone have been reported to reduce postoperative pain in humans with minimal side effects (Grundmann et al, 2006;Kampe et al, 2006). In our experiments, oral administration of the new MPF4, either pre-or postoperative, similar to dipyrone and morphine, markedly produced a decrease in mechanical allodynia induced by skin incision in a mouse model of postoperative pain.…”

Section: Discussionmentioning

confidence: 98%

Antinociceptive action of 4-methyl-5-trifluoromethyl-5-hydroxy-4, 5-dihydro-1H-pyrazole methyl ester in models of inflammatory pain in mice

Milano¹,

Rossato²,

Oliveira³

et al. 2008

Life Sciences

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“…These cases have presented both with (21) and without (22) other symptoms of allergic reaction such as bronchospasm or generalized skin rash. Studies of intravenous metamizol in surgical or critically ill patients have shown variable cardiovascular effects, ranging from no significant differences versus comparison group(s) to transient hypotension (23)(24)(25)(26)(27)(28). In one series of critically ill, febrile patients, metamizol infusion reduced MAP by an average of 10 mmHg at two hours post-infusion, with recovery to baseline by four hours (24).…”

Section: Discussionmentioning

confidence: 99%

Bradycardia and hypotension associated with fomepizole infusion during hemodialysis

Lepik¹,

Brubacher

DeWitt

et al. 2008

Clinical Toxicology

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We report a case of hypotension and bradycardia associated with intravenous fomepizole infusion. Case report. A 59-year-old man presented to hospital 10 hours after ethylene glycol ingestion with ataxia, slurred speech, metabolic acidosis, heart rate 70 /min, blood pressure 160/100 mmHg. Treatment with hemodialysis and fomepizole began 7.5 hours after admission. Severe bradycardia (29 /min) and hypotension (69 mmHg systolic) occurred immediately following a 30 minute intravenous infusion of the first (19 mg/kg) fomepizole dose, but rapidly corrected with 1 mg atropine. Transient bradycardia (48/min) and hypotension (89/57 mmHg) recurred immediately after the second (10 mg/kg) fomepizole dose, also given during dialysis. Discussion. Hemodialysis may cause a drop in blood pressure and heart rate; however, the close temporal relationship with fomepizole infusions, dose-related symptom intensity and recurrence with rechallenge suggest a causal relationship with fomepizole. Hemodialysis, acidosis and high initial fomepizole dose may have enhanced patient susceptibility, as a post-dialysis fomepizole dose was well tolerated. Conclusion. Fomepizole may precipitate bradycardia and/or hypotension during hemodialysis. Monitor vital signs closely during and immediately after infusion.

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Clinical equivalence of IV paracetamol compared to IV dipyrone for postoperative analgesia after surgery for breast cancer

Abstract: IV paracetamol 1 g is clinically equivalent to IV dipyrone 1 g for postoperative analgesia after surgery for breast cancer.

Cited by 45 publications

References 14 publications

Efficacy of Non-Opioid Analgesics on Opioid Consumption for Postoperative Pain Relief After Abdominal Hysterectomy

Efficacy of Non-Opioid Analgesics on Opioid Consumption for Postoperative Pain Relief After Abdominal Hysterectomy

Antinociceptive action of 4-methyl-5-trifluoromethyl-5-hydroxy-4, 5-dihydro-1H-pyrazole methyl ester in models of inflammatory pain in mice

Bradycardia and hypotension associated with fomepizole infusion during hemodialysis

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