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2008 | 80 | 5 | 263-270
Article title

Analysis of the Analgesic Effect of Metamizole Sodium in Patients Operated on for Goitre

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EN
Abstracts
EN
The aim of the study was to evaluate the analgesic effect of metamizole sodium administered intravenously during the day after surgery in patients operated on for nodular goitre - using the 11-point NAS scale (Numeric Analog Scale).Material and methods. The study was comprised of 114 patients who had undergone surgery for nontoxic: 84 (73.7%) or toxic: 30 (26.3%) nodular goitre. The goitre size, according to the WHO classification ranged between III and I° (2). I° goitre was found in 31 (27%) patients, II° goitre - in 46 (40.4%) patients and III° goitre - in 37 (32.4%) patients. The age of patients ranged between 22 and 75 years (median 53, IQR 43-61). The goitre was localized in the neck in 103 (90.4%) patients and it partially reached the superior aperture of the thorax with its lower poles in 11 (9.6%) patients. Patients with coexisting diseases such as diabetes mellitus or peripheral neuropathy were excluded from the study. Patients were randomly assigned to 4 groups. Group I included 38 subjects in whom metamizole sodium was applied at a dose of 1 g intravenously every 6 hours for a day after surgery; the first dose was administered at the moment of surgical wound closure. Group II included 37 patients in whom metamizole sodium was applied according to the above-mentioned regimen and, additionally the surgical wound was injected with 10 ml of bupivacaine 0.25%. Group III consisted of 36 patients in whom 1 g of metamizole was first administered intravenously thirty minutes before surgery and the subsequent doses were systematically repeated at time intervals of 6 hours (preemptive analgesia), avoiding buvacaine wound infiltration. Group IV included 40 patients in whom ketoprophen was administered intravenously at a dose of 0.1 g every 6 hours for a day after the procedure. Surgical wounds were not injected with buvacaine in these patients, similarly as in groups III and I. In case of severe pain patients could additionally receive morphine 1 mg on-demand.Results. Pain intensity was analyzed every 6 hours on NAS scale and pain scores ranged from 1 to 5.5. At all time points, the highest pain intensity scores were found in patients who received metamizole as monotherapy (group I) or ketoprofen (group IV), while the lowest were found in the groups where surgical wound was additionally injected with bupivacaine solution (group II) or additional metamizole dose was used before the procedure (group III). Patients from group II rated their pain intensity as slightly higher or similar to that in group III (statistically insiginficant). Similarly patients from group I had pain scores slightly higher or similar to scores reported in group IV (statistically insiginficant).Conclusions. 1. The most intense pain was observed during the first 12 hours after thyroid surgery. 2. Administration of metamizole sodium according to the regimen that was applied in groups II and III provided sufficient analgesia. 3. Infiltration of the surgical wound with buvacaine or administration of an additional dose of metamizole sodium prior to the surgery (preemptive analgesia) results in postoperative pain relief and allows avoiding demand for opioid analgetics.
Publisher

Year
Volume
80
Issue
5
Pages
263-270
Physical description
Dates
published
1 - 5 - 2008
online
9 - 6 - 2008
Contributors
  • Department of Endocrine Surgery, General and Angiovascular Surgery, Medical University, Łódź, Kierownik: prof. dr hab.
  • Department of Endocrine Surgery, General and Angiovascular Surgery, Medical University, Łódź, Kierownik: prof. dr hab.
  • Department of Endocrine Surgery, General and Angiovascular Surgery, Medical University, Łódź, Kierownik: prof. dr hab.
  • Department of Endocrine Surgery, General and Angiovascular Surgery, Medical University, Łódź, Kierownik: prof. dr hab.
  • Department of Endocrine Surgery, General and Angiovascular Surgery, Medical University, Łódź, Kierownik: prof. dr hab.
author
  • Department of Endocrine Surgery, General and Angiovascular Surgery, Medical University, Łódź, Kierownik: prof. dr hab.
References
  • Torres LM, Rodríguez MJ, Montero A et al.: Efficacy and safety of dipyrone versus tramadol in the management of pain after hysterectomy: a randomized, double-blind, multicenter study. Reg Anesth Pain Med 2001; 26: 118-24.[PubMed]
  • Hedinger C, Williams ED, Sobin LH: The WHO histological classification of thyroid tumors: a commentary on the second edition. Cancer 1989; 63: 908-11.[PubMed][Crossref]
  • Andrade SE, Martinez C, Walker AM: Comparative safety evaluation of non-narcotic analgesics. J Clin Epidemiol 1998; 51: 1357-65.[Crossref][PubMed]
  • Wordliczek J, Dobrogowski J: Treatment of postoperative and posttraumatic pain with non-opioid analgesic drugs. Ból 2004; 5: nr 136.
  • Weithmann KU, Alpermann HG: Biochemical and pharmacological effects of dipyrone and its metabolites in model systems related to arachidonic acid cascade. Arzneimittelforschung 1985; 35: 947-52.[PubMed]
  • Carlsson KH, Helmreich J, Jurna I: Activation of inhibition from the periaqueductal grey matter mediates central analgesic effect of metamizol (dipyrone). Pain 1986; 27: 373-90.[Crossref][PubMed]
  • Gómez MJ, Sirtori C, Mezcua M et al.: Photodegradation study of three dipyrone metabolites in various water systems: Identification and toxicity of their photodegradation products. Water Res 2008 Feb 2
  • Bannwarth B, Demotes-Mainard F, Schaeverbeke T et al.: Central analgesic effects of aspirin-like drugs. Fundam Clin Pharmacol 1995; 9: 1-7.[PubMed][Crossref]
  • Forster C, Magerl W, Beck A et al.: Differential effects of dipyrone, ibuprofen, and paracetamol on experimentally induced pain in man. Agents Actions 1992; 35: 112-21.[PubMed][Crossref]
  • Bagán JV, López Arranz JS, Valencia. et al.: Clinical comparison of dexketoprofen trometamol and dipyrone in postoperative dental pain. J Clin Pharmacol 1998; 38: 55S-64S.
  • Babej-Dölle R, Freytag S, Eckmeyer J et al.: Parenteral dipyrone versus diclofenac and placebo in patients with acute lumbago or sciatic pain: randomized observer-blind multicenter study. Int J Clin Pharmacol Ther 1994; 32: 204-09.
  • Gómez-Jiménez J, Franco-Patino R, Chargoy-Vera J et al.: Clinical efficacy of mild analgesics in pain following gynaecological or dental surgery: report on multicentre studies. Br J Clin Pharmacol 1980; 10: 355S-358S.[Crossref]
  • Daftary SN, Mehta AC, Nanavati M: A controlled comparison of dipyrone and paracetamol in post-episiotomy pain. Curr Med Res Opin 1980; 6: 614-18.[PubMed][Crossref]
  • Patel CV, Koppikar MG, Patel MS et al.: Management of pain after abdominal surgery: dipyrone compared with pethidine. Br J Clin Pharmacol 1980; 10: 351-54.[Crossref]
  • Daftary SN, Mehta AC, Nanavati M: A controlled comparison of dipyrone and paracetamol in post-episiotomy pain. Curr Med Res Opin 1980; 6: 614-18.[PubMed][Crossref]
  • Lal A, Pandey K, Chandra P et al.: Dipyrone for treatment of post-operative pain. Anaesthesia 1973; 28: 43-47.[PubMed][Crossref]
  • Paeile C, Gallardo F: Analgesic activity of pentazocine and dipyrone in ambulatory oral surgery patients. J Oral Surg 1974; 32: 191-94.[PubMed]
  • Rohdewald P, Drehsen G, Milsmann E et al.: Relationship between saliva levels of metamizol metabolites, bioavailability and analgesic efficacy. Arzneimittelforschung 1983; 33: 985-88.[PubMed]
  • Lanas A, Serrano P, Bajador E et al.: Risk of upper gastrointestinal bleeding associated with nonaspirin cardiovascular drugs, analgesics and nonsteroidal anti-inflammatory drugs. Eur J Gastroenterol Hepatol 2003; 15: 173-78.[Crossref]
  • Sharpe CR, Franco EL: Use of dipyrone during pregnancy and risk of Wilms' tumor. Brazilian Wilms' Tumor Study Group. Epidemiology 1996; 7: 533-35.[Crossref]
  • Catalán JL, Martínze L et al.: Oligoamnios associated with the use of magnesium dipyrone. 1995; 104: 541-43.[PubMed]
  • Martí Solé JJ, Pasarisas Sala M: A possible association between the maternal administration of metamizole and persistent pulmonary hypertension in a newborn infant. An Esp Pediatr 1996; 44: 387-88.
  • Martinez C, Reitbrock S: The adverse public health impact from short-term use of non-necrotic analgesics and non-steroidal antiinflammatory drugs from an epidemiologic perspective. Klinische Pharmakologie aktuell 1996; 7: 38-40.
  • Van der Klauw MM, Stricker BH, Herings RM et al.: A population based case-cohort study of drug-induced anaphylaxis. Br J Clin Pharmacol 1993; 35: 400-08.
  • Kaufman DW, Kelly JP, Jurgelon JM et al.: Drugs in the aetiology of agranulocytosis and aplastic anaemia. Eur J Haematol Suppl 1996; 60: 23-30.[PubMed]
  • Laporte JR, Carné X, Vidal X et al.: Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs. Catalan Countries Study on Upper Gastrointestinal Bleeding. Lancet 1991; 337: 85-89.[Crossref][PubMed]
  • Langman MJ, Weil J, Wainwright P et al.: Risks of bleeding peptic ulcer associated with individual non-steroidal anti-inflammatory drugs. Lancet 1994; 343: 1075-78.[Crossref][PubMed]
  • Henry D, Dobson A, Turner C: Variability in the risk of major gastrointestinal complications from nonaspirin nonsteroidal anti-inflammatory drugs. Gastroenterology 1993; 105: 1078-88.[PubMed]
  • Faulkner G, Prichard P, Somerville K et al.: Aspirin and bleeding peptic ulcers in the elderly. BMJ 1988; 297: 1311-13.[PubMed][Crossref]
  • Needham CD, Kyle J, Jones PF et al.: Aspirin and alcohol in gastrointestinal haemorrhage. Gut 1971; 12: 819-21.[Crossref][PubMed]
  • Armstrong CP, Blower AL: Non-steroidal anti-inflammatory drugs and life threatening complications of peptic ulceration. Gut 1987; 28: 527-32.[PubMed][Crossref]
  • Slattery J, Warlow CP, Shorrock CJ et al.: Risks of gastrointestinal bleeding during secondary prevention of vascular events with aspirin-analysis of gastrointestinal bleeding during the UK-TIA trial. Gut 1995; 37: 509-11.[Crossref][PubMed]
  • The International Agranulocytosis and Aplastic Anemia Study. Risks of agranulocytosis and aplastic anemia. A first report of their relation to drug use with special reference to analgesics. JAMA 1986; 256: 1749-57.[PubMed]
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_v10035-008-0034-1
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