Würzburg pain drip

The Würzburger Schmerztropf is an infusion mixture prepared with three different drugs ( tramadol and metamizole in a certain dose ratio, as well as dehydrobenzperidol ). It is used to treat moderate pain after operations ("pain drops").

history

The postoperative combined pain treatment (analgesia) by infusion of the weakly effective opioids tramadol and metamizole was introduced in 1986 at the University of Würzburg. In addition, the infusion solution then contained haloperidol and clomipramine , which were supposed to cause psychoactive dampening. These two components were later replaced by the antipsychotic and antiemetic active dehydrobenzperidol (droperidol).

Medicinal substances

The Würzburger Schmerztropf combines different active principles:

• Tramadol , which has only a slight respiratory depressive effect, is used as a weakly effective opioid . It acts as a weak agonist at opioid receptors in nervous tissue and by inhibiting the reuptake of noradrenaline into the nerve cell ( neuron ) and increasing the release of serotonin .

• a peripherally effective analgesic, metamizole as standard, is also used to increase pain reduction . Unlike other non-opioid analgesics , metamizole also has a spasmolytic effect.

• a neuroleptic and antiemetic agent such as dehydrobenzperidol is said to prevent side effects of high-dose tramadol such as nausea and vomiting.

So one can say that the third component fulfills an adjuvant function here . Alternatively, metoclopramide or dimenhydrinate can be used.

A fully electrolyte solution is used as the carrier solution .

Contraindications and intolerances

Contraindications and possible intolerance of the combination of three result from those of the individual components; the effect of the agent must be weighed against the risks of a fixed combination. It must also be evaluated beforehand whether this deprives the patient of the possibilities for more effective pain therapies.

literature

• Enno Freye: Opioids in Medicine. 8th, updated edition. Springer Medizin Verlag, Heidelberg 2010, ISBN 978-3-540-88797-3 . Page 119 f. ( limited preview in Google Book search).

Individual evidence

1. ↑ ^{a b c d} Freye, 2010; P. 119
2. ↑ ^{a b} U. Stamper, P. Henn: "Is the Würzburger Schmerztropf an alternative to iv PCA?": Contra. In: Anaesthesiology · Intensive Care Medicine · Emergency Medicine · Pain Therapy. Volume 35, 2000. pp. 30-34. doi : 10.1055 / s-2000-12156
3. ↑ V. Schreiber: Comparison of the analgesic effect of an intravenous infusion of tramadol, metamizole and an antiemetic ("Würzburger Schmerztropf") to an intravenous infusion of paracetamol and an intravenous infusion of parecoxib in postoperative pain therapy after orthopedic surgical interventions. Inaugural dissertation, Würzburg, 2010.
4. ↑ ^{a b} Freye, 2010; P. 120

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