n contribute to a postsurgical bleeding remains unanswered. Fact is that metamizol is one of the least well documented analgesic drugs [1] .

4. Conclusions

For ages metamizol was assumed to be “centrally acting” and apart from the rare agranulocytosis, it was free of side effects. Recent publications show strong efficacy of metamizol compared with paracetamol [17] . As it is assumed to be safe, the overall use of metamizol has multiplied in the last years [1] .

The dose of metamizol in postoperative pain management is up to 4 times 1000 mg a day, which is a quantity that clearly shows a platelet inhibiting effect [3] . Nevertheless it is used widely even in context with neurosurgery.

Further prospective studies are needed to document the dose related benefit or disadvantage of this old drug especially in context with postoperative pain management after neurosurgical interventions.

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