Single dose dipyrone for acute postoperative pain

Abstract

The editorial group responsible for this previously published document have withdrawn it from publication.

Metamizole-Associated Adverse Events: A Systematic Review and Meta-Analysis

“…We captured as many relevant studies as possible by including trials published in all languages, contacting the authors of studies published in the last 12 years and performing the additional reference list search. Because we included studies that examined metamizole for all indications, we were able to analyze 79 studies, while the three Cochrane reviews, which assessed clinical effectiveness only in postoperative pain, renal colic pain and acute primary headaches, analyzed 15 [ 2 ], 11 [ 3 ] and four [ 4 ] studies, respectively. We also included more patients; our study evaluated 8426 patients, while the Cochrane reviews evaluated 1436 [ 2 ], 1053 [ 3 ] and 636 [ 4 ].…”

“…We only considered the safety aspects of metamizole and did not evaluate efficacy, which the above-mentioned Cochrane reviews found was similar to that of other widely used analgesics for three different indications: postoperative pain, renal colic pain and acute primary headaches [ 2 – 4 ]. Given these findings, an analgesic should be chosen based on its safety profile.…”

“…Metamizole, or dipyrone, is a pyrazolone derivate whose structure is closely related to that of amidopyrine. It was launched commercially as an analgesic and antipyretic by Hoechst AG in 1922 [ 1 ], and is commonly used to treat postoperative pain, colic pain, cancer pain and migraine [ 2 – 4 ]. In many parts of the world, including most countries in the European Union and Latin America, it is the most popular non-opioid first-line analgesic and is sometimes even available over-the-counter.…”

“…There are no large randomized controlled trials or conclusive summaries of the existing literature [ 9 ]. Three current Cochrane reviews on the effectiveness and safety of metamizole for acute postoperative pain [ 2 ], acute renal colic pain [ 3 ], and acute primary headaches [ 4 ] concluded that metamizole offers good short-term pain relief. In each of these systematic reviews, however, the number of included participants was too small and the authors did not conduct a meta-analysis of safety issues, but they did associate metamizole with somnolence, gastric discomfort and nausea.…”

4‐Methylamino antipyrine determination in human plasma by high‐performance liquid chromatography tandem mass spectrometry

“…4-Methylamino antipyrine (MAA) is an active metabolite of metamizole (dypirone, MT), which is a nonopioid antipyretic analgesic (Arellano & Sacristan, 1990;Derry, Faura, Edwards, McQuay, & Moore, 2011;Gomez, Franco-Patino, Chargoy-Vera, & Olivares-Sosa, 1980). Metamizole was discovered in the beginning of the last century and was prohibited in several countries owing to its side effects (Andrade, Bartels, Lange, Sandford, & Gurwitz, 2016;Schug & Manopas, 2007).…”