Metamizole vs. ibuprofen at home after day case surgery: A double-blind randomised controlled noninferiority trial

Autor: Stefan Evers, Bjoern Stessel, Jean-Paul Ory, Elbert A.J. Joosten, Caroline Pelckmans, Marc Van de Velde, Sander M. J. van Kuijk, Michiel Boon, Wolfgang Buhre, Werner Wyckmans
Přispěvatelé: Anesthesiologie, MUMC+: MA Anesthesiologie (9), RS: MHeNs - R3 - Neuroscience, MUMC+: KIO Kemta (9), Epidemiologie, RS: CAPHRI - R2 - Creating Value-Based Health Care
Rok vydání: 2019
Předmět:
Male
LORNOXICAM
medicine.medical_treatment
Dipyrone
Administration
Oral
Ibuprofen
Self Administration
law.invention
0302 clinical medicine
Randomized controlled trial
030202 anesthesiology
law
Medicine
PARACETAMOL
Pain Measurement
Pain
Postoperative
digestive
oral
and skin physiology
PATIENT-CONTROLLED ANALGESIA
NONSTEROIDAL ANTIINFLAMMATORY DRUGS
Analgesics
Non-Narcotic
Middle Aged
Metamizole
AMBULATORY SURGERY
Acute Pain
DIPYRONE METAMIZOL
Treatment Outcome
Equivalence Trial
Patient Satisfaction
Anesthesia
Drug Therapy
Combination
Female
medicine.drug
Adult
INDUCED GASTRIC-ULCERS
digestive system
NONOPIOID ANALGESICS
03 medical and health sciences
Pharmacotherapy
Double-Blind Method
Lornoxicam
Humans
Acetaminophen
business.industry
Patient-controlled analgesia
030208 emergency & critical care medicine
EFFICACY
digestive system diseases
Anesthesiology and Pain Medicine
Ambulatory Surgical Procedures
POSTOPERATIVE PAIN RELIEF
business
Zdroj: European Journal of Anaesthesiology, 36(5), 351-359. LIPPINCOTT WILLIAMS & WILKINS
ISSN: 1365-2346
0265-0215
Popis: BACKGROUND NSAIDs and paracetamol are the cornerstones of pain treatment after day case surgery. However, NSAIDs have numerous contraindications and consequently are not suitable in up to 25% of patients. Metamizole is a non-opioid compound with a favourable gastro-intestinal and cardiovascular profile compared with NSAIDs.OBJECTIVES The study aimed to assess if a combination of metamizole and paracetamol is noninferior to a combination of ibuprofen and paracetamol in treating pain at home after painful day case surgery.DESIGN A double-blind randomised controlled trial.SETTING Single centre.PATIENTS Two hundred patients undergoing elective ambulatory haemorrhoid surgery, arthroscopic shoulder or knee surgery, or inguinal hernia repair.INTERVENTION Patients were randomly allocated to receive either metamizole and paracetamol (n = 100) or ibuprofen and paracetamol (n = 100) orally for four days.MAIN OUTCOME MEASURES Average postoperative pain intensity using a numerical rating scale and use of rescue medication were measured in the postanaesthesia care unit (PACU) and on postoperative days (POD) 1 to 3. A difference in mean numerical rating scale score of 1 point or less was considered noninferior. Adverse effects of study medication and satisfaction with study medication were measured on PODs 1 to 3 by telephone follow-up.RESULTS In the PACU, the difference in mean +/- SD pain score between metamizole and paracetamol and ibuprofen and paracetamol was 0.85 +/- 0.78. From POD 1 to 3, this difference was lower than 1, resulting in noninferiority. Rescue opioid consumption in the PACU and on PODs 1 and 3 was not significantly different between treatment groups. Rescue opioid consumption on POD2 was significantly higher in the ibuprofen and paracetamol group (P = 0.042). Adverse effects of study medication and overall patient satisfaction were similar in both groups.CONCLUSION Paracetamol/metamizole and paracetamol/ibuprofen are equally effective in treatment of acute postoperative pain at home after ambulatory surgery with comparable patient satisfaction levels.
Databáze: OpenAIRE
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