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Single dose dipyrone for acute postoperative pain.

Jayne Edwards¹, Fuensanta Meseguer, Clara Faura

¹Training Team, UK Cochrane Centre, National Institute for Health Research, Summertown Pavilion, Middle Way, Oxford, UK, OX2 7LG.

The Cochrane Database of Systematic Reviews

|September 9, 2010

Summary

Single dose dipyrone (metamizole) effectively relieves acute postoperative pain, with 70% of patients experiencing significant relief. This non-steroidal anti-inflammatory drug reduces the need for rescue medication compared to placebo.

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Area of Science:

Pharmacology
Pain Management
Evidence-Based Medicine

Background:

Dipyrone (metamizole) is a non-steroidal anti-inflammatory drug (NSAID) used for pain relief but is banned in some countries due to agranulocytosis risks.
This review updates a 2001 Cochrane review, seeking additional outcomes without identifying new studies.

Purpose of the Study:

To evaluate the efficacy and safety of single-dose dipyrone for acute postoperative pain management in adults.
To compare dipyrone's effectiveness against placebo and active controls.

Main Methods:

Systematic review and meta-analysis of randomized, double-blind, placebo or active-controlled trials.
Inclusion criteria: single dose, adults with moderate to severe postoperative pain, various administration routes (oral, rectal, IM, IV).
Efficacy assessed by pain relief, rescue medication use; adverse events and withdrawals were collected.

Main Results:

Oral dipyrone 500 mg provided at least 50% pain relief in over 70% of participants versus 30% for placebo (NNT 2.4).
Fewer participants required rescue medication with dipyrone (7%) compared to placebo (34%).
Intravenous dipyrone 2.5 g showed comparable efficacy to intravenous tramadol 100 mg; no serious adverse events were reported.

Conclusions:

Single-dose dipyrone 500 mg offers substantial pain relief for approximately 70% of patients with acute postoperative pain.
Dipyrone is effective in reducing the need for supplementary pain medication.
The review highlights dipyrone's efficacy based on limited data, emphasizing its benefit-risk profile in specific contexts.