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British Journal of Anaesthesia, 2000, Vol. 85, No. 2 217-223
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Use of intravenous patient-controlled analgesia for the documentation of synergy between tramadol and metamizol

A. Montes, W. Warner1,2 and M. M. Puig1,*

1Anaesthesiology Research Unit, IMIM, Department of Anaesthesiology, Hospital Universitario del Mar, Paseo Maritimo 25, E-08003 Barcelona, Spain. 2Department of Pharmacology, New York University College of Dentistry, New York, USA

The quantification of the synergistic interactions (beneficial and adverse) of analgesic drug combinations in humans has been elusive. We propose a new procedure based on analgesic requirements (i.v.-PCA) and pain intensity (VAS-PI). One hundred and one post-hysterectomy patients received at the time of analgesia request (TAR) tramadol (100 mg, group I) or metamizol (1.2 g, group II) alone, or combined in 1:1 (III), 1:0.3 (IV) or 1:3 ratio (V). After 15 min, they received the same treatment by PCA. VAS-PI, analgesic consumption and adverse effects were assessed at TAR, and periodically for 24 h. Data were analysed using interaction indexes and isobolograms. All treatments produced equivalent VAS-PI, per cent efficacy and adverse effects. When drugs were combined in a 1:1 ratio, synergy was present for the analgesic and adverse effects; all other treatments were additive.

Br J Anaesth 2000; 85: 217–23

* Corresponding author


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