Metamizole (Dipyrone) role in postoperative analgesia in NSAIDs contraindicated patients
Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most widespread pain relievers that plays an eminent role in the multimodal pain management. But, managing pain is often disputed in the patients with contraindication for NSAIDs. According to a current Dutch anesthesiology guideline, use of metamizole (dipyrone) in such patients has been promoted.
Earlier, the use of metamizole was not encouraged due to its risk for agranulocytosis. A study was employed to draw the efficiency of metamizole as an alternative to classical NSAIDs and opioids in postoperative pain management despite the drawbacks. This work was based on the literature review and pharmacovigilance research of the World Health Organization adverse effect registrations.
The outcomes revealed that metamizole induced lesser gastric and duodenal ulcers than other nonselective NSAIDs and the risk for bleeding is finite. Although, it is still not known whether it is more secure than a nonselective NSAID merged with a proton pump inhibitor. The drug appears to be harmless for renal function in the healthy volunteers but the evidences in the most vulnerable patients (e.g., with heart or renal failure) is still limited. The prevalence of metamizole-induced agranulocytosis is controversial, but the risk is likely to be insufficient with short-term postoperative use in these patients.
It can be culminated that metamizole may be innocuous for upper intestinal tract and kidneys than other NSAIDs. It could be alternatively used in patients with an increased risk for stomach or renal problems. Thus, the upgraded postoperative pain relief can potentially be attained. The possibility for metamizole-induced agranulocytosis is deemed to be admissible.