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[Differential administration of non-opioids in postoperative analgesia, I. Quantification of the analgesic effect of metamizole using patient-controlled analgesia].

AbstractOBJECTIVE:
The aim of this study was to investigate: 1. Whether the perioperative administration of metamizol causes a significant reduction in postoperative opioid requirements within the first 24 h after surgery. 2. The opioid-sparing effect after different types of operations. 3. Whether preoperative application of metamizol causes a significant reduction of the pain-score immediately after operation.
METHODS:
In a double-blind, randomised, placebo-controlled study, 117 patients, scheduled for minor orthopaedic or laparoscopic surgery or other operations (mainly resection of the thyroid gland and inguinal herniotomies) received either metamizol (1 g/100 ml NaCl 0.9%) or placebo (100 ml NaCl 0.9%) intravenously over 15 min in three separate doses: the first dose was given just before induction and the others 6 h and 12 h later. After surgery all patients were allowed to self-administer buprenorphine from a PCA (patient-controlled analgesia) pump (Bolus: 30 microgram, lockout: 5 min in the recovery room, 30 min on the ward). Every hour for the first 6 h and after 24 h, cumulated doses of buprenorphine, pain scores (0-10), blood pressure, pulse and side effects were recorded.
RESULTS:
After minor orthopaedic and laparoscopic surgery, metamizol-treated patients had significantly less pain immediately after surgery and used a significantly lower cumulated dose of opioid in the first 24 h after surgery (-20% and -67% respectively) than patients receiving placebo. After the other types of surgery no analgesic effect could be established.
CONCLUSIONS:
Perioperative administration of metamizol results in better pain relief and significantly lower buprenorphine requirements particularly after laparoscopic operations. To achieve a significant pain reduction immediately after the operation, the first dose should be applied before induction.
AuthorsP Steffen, I Schuhmacher, T Weichel, M Georgieff, W Seeling
JournalAnästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS (Anasthesiol Intensivmed Notfallmed Schmerzther) Vol. 31 Issue 3 Pg. 143-7 (Apr 1996) ISSN: 0939-2661 [Print] GERMANY
Vernacular TitleUntersuchungen zum differenzierten Einsatz von Nichtopioiden zur postoperativen Analgesie I. Quantifizierung des analgetischen Effektes von Metamizol mittels der patientenkontrollierten Analgesie.
PMID8672615 (Publication Type: Clinical Trial, Comparative Study, English Abstract, Journal Article, Randomized Controlled Trial)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Dipyrone
Topics
  • Adolescent
  • Adult
  • Aged
  • Analgesia, Patient-Controlled
  • Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, adverse effects)
  • Dipyrone (administration & dosage, adverse effects)
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative (drug therapy, etiology)
  • Preanesthetic Medication

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