Metamizole vs. ibuprofen at home after day case surgery

Stessel, Bjoern; Boon, Michiel; Pelckmans, Caroline; Joosten, Elbert A.J.; Ory, J. P.; Wyckmans, Werner; Evers, Stefan; Kuijk, Sander M. J. van; Velde, Marc Van de; Buhre, W.

doi:10.1097/eja.0000000000000972

Cited by 13 publications

(4 citation statements)

References 47 publications

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“…In this propective and observational survey, we analyzed the data from a large randomized trial to evaluate whether or not metamizole combined with paracetamol is non-inferior compared to ibuprofen combined with paracetamol in the treatment of postoperative pain after different types of ambulant surgery at the JESSA Hospital Hasselt, Belgium. These data have been published in the European Journal of Anaesthesiology (17). The study protocol was already published in Trials (2).…”

Section: Methodsmentioning

confidence: 99%

Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

et al. 2020

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Background: Nowadays, complicated and painful surgical procedures are encouraged to be carried out in an ambulatory setting. Objectives: The current study aimed to assess 4-week postoperative pain profiles of 4 painful ambulatory surgical procedures. We analyzed the prevalence of and reasons for non-adherence and partial adherence of patients to a predefined treatment schedule after the ambulant surgery. Methods: The current study analyzed data from a large randomized trial by evaluating the effect of postoperative pain medication on acute postoperative pain at home during the first 4 postoperative days (POD) in patients scheduled for ambulatory hemorrhoid surgery, shoulder or knee arthroscopy, and inguinal hernia repair. Postoperative pain intensity was assessed at POD 0, 1, 2, 3, 4, 7, 14, and 28 via the Numeric Rating Scale (NRS). Adherence was assessed on POD 1, 2, 3, and 4. Results: Median average pain scores were above an NRS of 3 during the first postoperative week after shoulder arthroscopy and even above 4 during the first postoperative week after hemorrhoid surgery. 26% of patients undergoing shoulder arthroscopy and hemorrhoid surgery still had moderate pain 1 week after surgery. Median average pain scores were below an NRS of 3 during the whole study period after inguinal hernia repair and knee arthroscopy. 24.61% of patients did not use the study medication as prescribed, 5.76% of whom were non-adherent, and 18.85% were partially adherent. Conclusions: Each type of ambulant surgery has its unique postoperative pain profile. New strategies should be developed for pain therapy at home, particularly after the ambulatory arthroscopic shoulder surgery and hemorrhoid surgery. Non-adherence is uncommon if they are provided with a multimodal analgesic home kit together with clear verbal, written instructions, and intensive follow-up.

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Section: Methodsmentioning

confidence: 99%

Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

et al. 2020

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“…Ibuprofen is commonly used drug for also its analgesic and antipyretic e cacies over different age groups (26). These two drugs had comparable safety pro les with regard to serious adverse effects, renal impairment, gastrointestinal hemorrhage, liver toxicity, and asthma (27).…”

Section: Discussionmentioning

confidence: 96%

Antipyretic Effect of Oral Dipyrone (Metamizole) Compared to Oral Ibuprofen in febrile Children: A Systematic Review and Meta-Analysis

Alnajar,

Saker,

Haji

et al. 2023

Preprint

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Background The nonsteroidal anti-inflammatory medication dipyrone (metamizole) is most frequently used as a painkiller as well as an anti - pyretic. Despite the fact that it has been banned in many high-income countries following confirmed studies of fatal agranulocytosis and adverse drug reactions, it is still widely used in various countries of the world. However, the antipyretic therapeutic indications of dipyrone in febrile children are currently unknown, and there is little information on the advantages and disadvantages of using dipyrone in febrile youngsters. In febrile youngsters, we expected that dipyrone's antipyretic effectiveness wouldn't be any more effective than ibuprofen. Therefore, the purpose of this research is to evaluate the effectiveness of oral dipyrone and oral ibuprofen as antipyretics in febrile children. Methods Several databases, including PubMed, Scopus, Web of Science, and Cochrane Library, were searched thoroughly using a pre-established search strategy for potential research. The studies included in this analysis comprised randomized controlled trials that compared the antipyretic effects of oral ibuprofen and oral dipyrone in febrile kids. Data analysis was carried out using Revman 5.4 software. Results Three studies were selected among the 27 publications we discovered to be applicable, and they underwent qualitative and quantitative analysis. The pooled analysis revealed no discernible difference between oral dipyrone and oral ibuprofen in terms of their antipyretic effects (Mean difference (MD) = 0.06; 95% confidence interval (CI): -0.08, 0.20). Conclusion Both oral dipyrone and ibuprofen are effective in reducing high-temperature levels in febrile children without any significant difference.

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“…These results are in agreement with recent reports. A secondary analysis of data from a large randomised trial comparing the analgesic efficacy of metamizole and ibuprofen orally at home in patients undergoing ambulatory haemorrhoid surgery, arthroscopic shoulder or knee surgery, or inguinal hernia repair, 32 showed that mean pain scores on movement were highest during the first 3 POD after shoulder arthroscopy (NRS >5, indicating severe pain). 11 This study also noted that mean pain Rebound pain after peripheral nerve block for ambulatory surgery is defined as the transition from well controlled pain (NRS <3) while the block is working to severe pain (NRS >5) within 24 h of block performance.…”

Section: Discussionmentioning

confidence: 99%

Additive or synergistic analgesic effect of metamizole on standard pain treatment at home after arthroscopic shoulder surgery

Stessel

Lambrechts

Evers

et al. 2023

European Journal of Anaesthesiology

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BACKGROUND There is growing evidence that the analgesic effect of metamizole is mediated at least partly by central mechanisms, including the endocannabinoid/endovanilloid system. Consequently, metamizole may have additive or even synergistic analgesic effects with paracetamol and nonsteroidal anti-inflammatory drugs (NSAID).OBJECTIVE This study aimed to assess if triple therapy with metamizole, ibuprofen and paracetamol (MIP) is superior to double therapy with ibuprofen and paracetamol (i.p.) in treating pain at home after ambulatory arthroscopic shoulder surgery. DESIGN/SETTING/PATIENTS/INTERVENTIONIn this double-blind, controlled, high-volume single centre, superiority trial, 110 patients undergoing elective ambulatory arthroscopic shoulder surgery were randomised to receive either MIP (n ¼ 55) or i.p. (n ¼ 55) orally for 4 days between December 2019 and November 2021. Pain intensity at movement and rest, using a numeric rating scale (NRS), perceived pain relief, use of rescue medication and adverse effects of study medication were recorded at the postanaesthesia care unit (PACU) and on postoperative day (POD) 1 to 4 and 7. Quality of Recovery (QoR) and satisfaction with study medication were measured at POD 7 with telephone follow-up. MAIN OUTCOME MEASUREThe primary outcome measure was postoperative pain intensity on movement measured by an 11-point NRS (where 0 ¼ no pain and 10 ¼ worst pain imaginable) on POD 1. RESULTSFor the primary outcome, superiority of MIP in reducing postoperative pain at movement on POD 1 was not confirmed: mean difference NRS [95% confidence interval (CI), À0.08 (À1.00 to 0.84)]. For pain on movement and at rest, no significant differences were found between groups in the PACU nor on POD 1 to 4 or day 7. Nausea was reported significantly more frequently in the metamizole group (22.6 vs. 58.5.; P < 0.001). Other adverse effects of study medication, rescue opioid consumption, perceived pain relief, QoR at POD 7, and overall patient satisfaction were similar in both groups.CONCLUSION Clinically, triple oral treatment with metamizole, paracetamol and ibuprofen is not superior to oral paracetamol and ibuprofen in multimodal pain treatment at home after ambulatory arthroscopic shoulder surgery. TRIAL REGISTRATION European Union Clinical Trials Register 2019-002801-23 and Clinicaltrials.gov NCT04082728.

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Metamizole vs. ibuprofen at home after day case surgery

Cited by 13 publications

References 47 publications

Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

Antipyretic Effect of Oral Dipyrone (Metamizole) Compared to Oral Ibuprofen in febrile Children: A Systematic Review and Meta-Analysis

Additive or synergistic analgesic effect of metamizole on standard pain treatment at home after arthroscopic shoulder surgery

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