Author(s)

Dagmar Wildpaner¹, Beat Flueckiger¹, Urs Dieter Schmid², Dominik Weishaupt³, Robert Theiler¹

¹Department of Rheumatology, Stadtspital Triemli, Zurich, Switzerland.
²Division of Neurosurgery, Stadspital Triemli, Zurich, Switzerland.
³Department of Radiology, Stadtspital Triemli, Zurich, Switzerland.

The use of metamizol significantly increased in the last decade, especially in non US countries [1]. Although metamizol is known to be a non selective COX inhibitor and therefore has platelet inhibiting potential, it is widely used in pain management in postsurgical setting. Methods: We present a case of bleeding after microsurgical decompression of a narrow lumbar spinal canal. Our patient developed a bleeding complication 3 days after the surgery. The bleeding spontaneously resolved after stopping the application of metamizol. Metamizol is a non selective COX inhibitor and is used as standard analgetic drug after surgery in our department, whereas other COX inhibitors are not. We made an intensive literature research to evaluate the prohaemorrhagic potential of metamizol. Metamizol has proven dose dependent platelet inhibiting effect. Conclusions: This is a quite ordinary case and there is no proof of metamizol being responsible for the bleeding in this case, it still poses questions at our daily routine and the question about a dose dependent clinically relevant prohaemorrhagic effect of metamizol remains unanswered. A proper study is needed.

Metamizol, Narrow Lumbar Spinal Canal, Postsurgical Analgesia, Bleeding Complication

Wildpaner, D. , Flueckiger, B. , Schmid, U. , Weishaupt, D. and Theiler, R. (2015) Can High Dose Metamizol Medication Contribute to Postsurgical Hemorrhage:A Case Report. Open Journal of Modern Neurosurgery, 5, 53-58. doi: 10.4236/ojmn.2015.52009.