Addition of metamizole to paracetamol at home after painful ambulatory arthroscopic shoulder surgery

Abstract

The use of nonsteroidal anti-inflammatory medications (NSAIDs) may be harmful in tendon healing. Consequently , NSAIDs have been abandoned in the pain management of patients at home following outpatient arthroscopic shoulder surgery with tendon repair. Para-cetamol in combination with rescue tramadol and a preoperative ultrasound-guided single-shot interscalene block (ISB) of the brachial plexus comprises the standard pain treatment model at the JESSA Hospital Hasselt for these patients. In the post anaesthesia care unit, bolus injections of piritramide (2 mg i.v.) are given until a numeric pain rating scale (NRS) 3 is achieved. Metamizole (dipyrone) is a nonopioid compound that has strong spasmolytic, analgesic, and antipyretic qualities. Recently, in a double-blind trial, prospective, randomised, controlled trial, we demonstrated that triple oral treatment with metamizole, paracetamol and ibupro-fen was not superior to oral paracetamol and ibuprofen in