Abstract
Purpose
Non-opioid analgesics are frequently used for the treatment of acute and chronic pain. Dipyrone is an alternative to NSAIDs and paracetamol, however, data on the frequency of its usage by anaesthesiologists in the perioperative and chronic pain setting are lacking and its adverse reactions are a matter of debate.
Methods
The link to a questionnaire on the use of non-opioid analgesics (NSAIDs, COX2 inhibitors, paracetamol, dipyrone) and the safety of dipyrone in the perioperative and chronic pain setting was mailed to anaesthesiologists and pain physicians.
Results
A total of 2237 responses were analysed. 97.4% of the respondents used non-opioid analgesics for the treatment of acute pain, with 93.8% administering dipyrone, 54.0% NSAIDs, 41.8% COX2-inhibitors and 49.2% paracetamol. Non-opioid analgesics were administered preoperatively by 22.3%, intraoperatively by 86.1% and postoperatively by 73% of the respondents. For chronic pain management, 76.7% of the respondents prescribed oral dipyrone in combination with other non-opioid analgesics. 19.9% used dipyrone as sole non-opioid, whereas 2.9% denied its use. Cases of dipyrone associated agranulocytosis were observed by 3.5% of the respondents of the acute and 1.5% of the chronic pain questionnaire, respectively. The majority of respondents (acute pain: 73.0%, chronic pain 59.3%) performed no blood cell counts to monitor dipyrone therapy. Patients were rarely informed about possible adverse drug reactions.
Conclusions
Dipyrone is the preferred non-opioid analgesic in the perioperative and chronic pain setting. Although cases of agranulocytosis occur, benefits apparently outweigh the risks according to anaesthesiologists. Measures like patient information may improve safety.
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