Intravenous dipyrone for the acute treatment of episodic tension-type headache: a randomized, placebo-controlled, double-blind study.
Acute headaches are responsible for a significant percentage of the case load at primary care units and emergency rooms in Brazil. Dipyrone (metamizol) is easily available in these settings, being the most frequently used drug. We conducted a randomized, placebo-controlled, double-blind study to assess the effect of dipyrone in the acute treatment of episodic tension-type headache. Sixty patients were randomized to receive placebo (intravenous injection of 10 ml saline) or 1 g dipyrone in 10 ml saline. We used seven parameters of analgesic evaluation. The patients receiving dipyrone showed a statistically significant improvement (P<0.05) of pain compared to placebo up to 30 min after drug administration. The therapeutic gain was 30% in 30 min and 40% in 60 min. The number of patients needed to be treated for at least one to have benefit was 3.3 in 30 min and 2.2 in 60 min. There were statistically significant reductions in the recurrence (dipyrone = 25%, placebo = 50%) and use of rescue medication (dipyrone = 20%, placebo = 47.6%) for the dipyrone group. Intravenous dipyrone is an effective drug for the relief of pain in tension-type headache and its use is justified in the emergency room setting.
Bigal
M E
ME
Departmet of Neurology, Albert Einstein School of Medicine, Bronx, NY, USA. marcelobigal@hotmail.com
Bordini
C A
CA
Speciali
J G
JG
D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004177:Dipyrone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D010147:Pain Measurement; D018781:Tension-Type Headache / Q000188:drug therapy*; D016896:Treatment Outcome
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004177:Dipyrone