Impact of analgesic regimen on patient outcome following subarachnoid hemorrhage: positive adjuvant effects of metamizole

SOLÁR, Peter, Marek JOUKAL, Čeněk ŠILAR and Radim JANČÁLEK. Impact of analgesic regimen on patient outcome following subarachnoid hemorrhage: positive adjuvant effects of metamizole. British journal of neurosurgery. ABINGDON: TAYLOR & FRANCIS LTD, 2024. ISSN 0268-8697. Available from: https://dx.doi.org/10.1080/02688697.2022.2151563.

Basic information

Original name

Impact of analgesic regimen on patient outcome following subarachnoid hemorrhage: positive adjuvant effects of metamizole

Authors

SOLÁR, Peter, Marek JOUKAL, Čeněk ŠILAR and Radim JANČÁLEK

Edition

British journal of neurosurgery, ABINGDON, TAYLOR & FRANCIS LTD, 2024, 0268-8697

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Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 1.100 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1080/02688697.2022.2151563

UT WoS

000893510100001

Keywords in English

Subarachnoid hemorrhage; analgesic drugs; metamizole; patient outcome; hydrocephalus

Tags

14110131, 14110514

Tags

International impact, Reviewed

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Abstract

V originále

IntroductionVarious analgesics are used to control intense headaches in patients following subarachnoid hemorrhage. In addition to pain control, it has been shown that some analgesics can affect various pathophysiological cascades. Therefore, we devised a study to assess whether the use of metamizole has a significant impact on the development of ischemic complications, hydrocephalus, and the overall outcome in patients following aneurysmal subarachnoid hemorrhage in the context of the other non-opioids and opioids effects.MethodsIn our retrospective, single-center cohort study, we enrolled 192 patients diagnosed with subarachnoid hemorrhage. We recorded their initial clinical status, comorbidities, and the daily dosage of analgesics over 14 days of hospitalization after the onset of subarachnoid hemorrhage. Using univariate and subsequent multivariate logistic regression analysis, we assessed the influence of various factors, including analgesics, on the development of delayed cerebral ischemia and hydrocephalus, as well as on 2-week and 6-month outcomes.ResultsAlthough the administration of non-opioids, in general, had no effect on the development of delayed cerebral ischemia or hydrocephalus, the use of metamizole as the main analgesic was associated with a significantly lower chance of poor outcome at both 2-weeks and 6-months, as well as the development of delayed cerebral ischemia. As opioids were indicated primarily for analgosedation in mechanically ventilated patients with poor clinical status, their usage was associated with a significantly higher chance of poor outcome, delayed cerebral ischemia, and hydrocephalus.ConclusionOur results suggest that the prescription of metamizole may be associated with better outcomes and a lower chance of delayed cerebral ischemia development in patients after subarachnoid hemorrhage. Considering the retrospective nature of our study and the limited worldwide availability of metamizole due to its prohibition in some countries, our results do not demonstrate a clear benefit but rather justify the need for subsequent prospective studies.