Tramadol drug is used for pain relief
Tramadol (generic for Ultram) is a prescription medication used for the management of moderate to moderately severe pain. Tramadol® has been prescribed to more than 55 million patients worldwide; Ultram® has been prescribed to more than 21 million patients in the U.S.

Increasing importance of opioids in geriatrics.

[Article in German]

Schuler M, Oster P.

Bethanien-Krankenhaus, Geriatrisches Zentrum an der Universitat Heidelberg, .

BACKGROUND: During the previous 20 years the prescription of opioids for medical use has increased steadily. Patients and professionals have great reservations about the use of opioids in the elderly. The aim of this study was to describe the changes in analgesic therapy in a geriatric clinic during the previous 10 years.METHOD: The quality and quantity of prescriptions for opioids as well as the costs of the analgesic therapy in a large geriatric clinic between 1994 and 2003 were analyzed.RESULTS: The use of opioids increased steadily from 0.72 mg per day and patient in 1994 to 9.50 mg in 2003 (1320%). The introduction of sustained release tilidine/naloxone and tramadol led to a change of the prescribed forms but only to a slight increase in the total consumption of these drugs. In 1994 the average daily cost of analgesic therapy was 15 cents per patient compared with 46 cents in 2003. The percentage of analgesics in the pharmacological budget increased from 5.6 to 10.8%.CONCLUSION: Dealing with opioids should be a part of the training program for all members of the geriatric team. Analgesics have come to play an important role in the pharmacological budget at least in this geriatric clinic.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15580360&query_hl=2

A review of the efficacy and safety of opioid analgesics post-craniotomy.

Roberts G.

Department of Anaesthetics, Neath-Port Talbot Hospital, Bro-Morgannwg NHS Trust, South Wales, UK. gemma.roberts@bromor-tr.wales.nhs.uk

--Codeine phosphate is the most commonly used analgesic post-craniotomy. --It is argued, in this paper, that codeine phosphate is an unpredictable pro-drug that does not equate to a safe and effective method of providing analgesia post-craniotomy. --Lack of evidence supporting tramadol's usage and concerns over its interactions and side effects mean its use cannot be advocated. --The traditional justification for withholding morphine in post-craniotomy pain appears to be largely based on anecdotal evidence. --Raising awareness among critical care nurses of the pharmacological properties of the analgesics used is imperative, if post-craniotomy pain is to be adequately treated. --There is an explicit challenge to the neurosurgical community to re-evaluate their pain-management strategies in the post-craniotomy patient.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15575637&query_hl=2

Premedication with tramadol in patients undergoing colonoscopy: a double-blind randomized placebo-controlled study.

Grossi L, Cappello G, Marzio L.

Department of Medicine and Sciences of Aging, School of Gastroenterology, Unit of Internal Medicine I, Ospedale Spirito Santo, Pescara, Italy. l.grossi@unich.it

Colonoscopy is often disturbed by poor patient tolerance; benzodiazepines or opiates are routinely used to overcome such problems, despite the possibility of undesired effects. Tramadol, an opiate analogue with potentially fewer side effects, has not been tested yet to this end. The aim of the study was therefore to evaluate the efficacy of tramadol as a premedication for the colonoscopic procedure. Fifty patients were randomly allocated to receive an i.v. infusion of 100 ml saline, with 100 mg tramadol or alone, before endoscopy. At the end of the procedure patients were asked to score the discomfort experienced and to give an exam evaluation. The endoscopist also analyzed his performance. Tramadol patients reported a pain score of 39 +/- 10 (mean +/- SE), compared to 45 +/- 8 for the placebo group (P = 0.25); the evaluation of endoscopy was also similar (tramadol, 66 +/- 12; placebo, 70 +/- 9; P = 0.15). The endoscopist also reported a similar score (65 +/- 4 after tramadol; 69 +/- 4 after placebo; P = 0.2). No significant sex- or age-related differences were detected. We conclude that tramadol, at least as a monotherapy, seems scarcely effective for controlling pain evoked by colonoscopy.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15573919&query_hl=2

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