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Metamizole sodium + paracetamol is a combination of two non-opioid analgesic and antipyretic agents used for the management of acute pain. Metamizole sodium, a pyrazolone derivative, provides potent analgesic, antipyretic, and spasmolytic effects, likely through the inhibition of cyclooxygenase (COX) enzymes and modulation of the endogenous cannabinoid and opioid systems. Paracetamol (acetaminophen) is a para-aminophenol derivative that primarily acts by inhibiting prostaglandin synthesis in the central nervous system. This specific combination was evaluated as a rescue analgesic regimen in a historical cohort study conducted by Istanbul University, focusing on postoperative pain management in patients undergoing bilateral reduction mammoplasty as an adjunct to thoracic paravertebral blocks.
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