ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
This article is part of the Research TopicPharmacist and patient safety: Focus on drug safetyView all 20 articles
The Effect of Scheduled Metamizole on Opioid Consumption after Cardiac Surgery
Provisionally accepted
Michal Slevin-Kish1*
Chen Seidenberg1*
Adina Grunberger1*
Ruth Mishali1Avi Hefets1
Pierre Singer2,3Eric sitton1- 1Ariel University Dr Miriam and Sheldon G Adelson School of Medicine, Ari'el, Israel
- 2Reichman University, Herzliya, Israel
- 3Rabin Medical Center, Petah Tikva, Israel
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This retrospective study evaluates the impact of implementing a standardized scheduled metamizole dosing protocol within a multimodal analgesia approach after cardiac surgery. The results showed that scheduled metamizole administration was associated with lower opioid consumption, while maintaining adequate pain control and safety. Pain scores measured by the Numeric Rating Scale improved from 1.12 pre-protocol to 0.89 post-protocol (p < 0.0001). Mean opioid consumption decreased from 119.51 mg morphine equivalents to 95.91 mg (p < 0.0001). No cases of clinically relevant agranulocytosis or persistent neutropenia were observed. Renal function, assessed by changes in serum creatinine, showed no significant differences between groups, suggesting renal safety. Despite improved analgesia and reduced opioid use, hospital length of stay increased slightly, potentially due to confounding factors. Our findings support scheduled metamizole as a safe and effective opioid-sparing agent in postoperative cardiac surgery pain management. Further prospective randomized trials are warranted to confirm these results and establish optimal protocols.
Keywords: cardiac surgeries, Metamizol, Multimodal analgesia, opiod analgesics, Pain Management, post operation care
Received: 14 Dec 2025; Accepted: 14 Jan 2026.
Copyright: © 2026 Slevin-Kish, Seidenberg, Grunberger, Mishali, Hefets, Singer and sitton. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Michal Slevin-Kish
Chen Seidenberg
Adina Grunberger
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