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.

Tramadol-associated pericarditis.

Krantz MJ, Garcia JA, Mehler PS.

Tramadol, marketed as Ultram in the United States, is as a non-scheduled narcotic analgesic based on its low abuse liability. It is indicated for the treatment of moderately severe pain; however, multiple adverse effects have been reported with its use including seizures, anaphylaxis, angioedema, bronchospasm, and serotonin syndrome. An association between tramadol and pericarditis has not been previously reported. We describe the case of an 88 year-old male who developed acute pericarditis 2 days following tramadol initiation. The temporal relationship between drug initiation and pericarditis as well as the resolution of symptoms upon drug discontinuation suggested a potential association. Although pericarditis has not been described with tramadol administration, clinicians should be aware of a possible association.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15771942&query_hl=2

[Celecoxib and Tramadol as an alternative osteoarthrosis therapy in patients with NSAID gastropathy]

[Article in Russian]

[No authors listed]

OBJECTIVE: To determine whether it is possible to continue the anti-inflammatory NSAID therapy of osteoarthrosis patients with the NSAID-induced duodenal ulcer. The results of the treatment of 38 patients with osteoarthrosis of II-III degrees in which the NSAID treatment was complicated with duodenal ulcers were analyzed. The treatment of 20 osteoarthrosis patients was carried out with the help of Celecoxib while 18 patients were on Tramadol as an analgesic therapy against a standard antiulcer therapy. The efficacy of osteoarthrosis treatment was assessed based on the pain syndrome dynamics by the VAS and functional Lequin test; the efficacy of duodenal ulcer treatment was assessed on the basis of clinical signs dynamics under EGD (esophagogastroduodenoscopy). A clinical remission (the endoscopy confirmed the healing of the ulcerous affection) was achieved in 19 Celecoxib patients with duodenal ulcer and osteoarthrosis, and 18 Tramadol patients with osteoarthrosis and duodenal ulcer against a standard antiulcer therapy. Celecoxib can serve as a drug of choice for continuing the anti-inflammatory and analgesic therapy in patients with osteoarthrosis and NSAID gastropathy.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15770856&query_hl=2

Oral analgesics for acute nonspecific pain.

Sachs CJ.

University of California, Los Angeles, Emergency Medicine Center, Los Angeles, California, USA. csachs@ucla.edu

Physicians most often recommend or prescribe oral medication for relief of acute pain. This review of the available evidence supports the use of acetaminophen in doses up to 1,000 mg as the initial choice for mild to moderate acute pain. In some cases, modest improvements in analgesic efficacy can be achieved by adding or changing to a nonsteroidal anti-inflammatory drug (NSAID). The safest NSAID is ibuprofen in doses of 400 mg. Higher doses may offer somewhat greater analgesia but with more adverse effects. Other NSAIDs have failed to demonstrate consistently greater efficacy or safety than ibuprofen. Although they may be more expensive, these alternatives may be chosen for their more convenient dosing. Cyclooxygenase-2 inhibitors provide equivalent efficacy to traditional NSAIDs but lack a demonstrable safety advantage for the treatment of acute pain. For more severe acute pain, the evidence supports the addition of oral narcotic medications such as hydrocodone, morphine, or oxycodone. Specific oral analgesics that have shown poor efficacy and side effects include codeine, propoxyphene, and tramadol.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15768621&query_hl=2

A clinical and pharmacologic review of skeletal muscle relaxants for musculoskeletal conditions.

Beebe FA, Barkin RL, Barkin S.

New World Health, Division of Nelson Communications Co. Inc., 202 Carnegie Center, Suite 101, Princeton, NJ 08540, USA. fbeebe@nelsoncomm.com

Muscle strains and other musculoskeletal disorders (MSDs) are a leading cause of work absenteeism. Muscle pain, spasm, swelling, and inflammation are symptomatic of strains. The precise relationship between musculoskeletal pain and spasm is not well understood. The dictum that pain induces spasm, which causes more pain, is not substantiated by critical analysis. The painful muscle may not show EMG activity, and when there is, the timing and intensity often do not correlate with the pain. Clinical and physiologic studies show that pain tends to inhibit rather than facilitate reflex contractile activity. The decision to treat and choice of therapy are largely dictated by the duration, severity of symptoms, and degree of dysfunction. Trigger point injections are sometimes used with excellent results in the treatment of muscle spasm in myofacial pain and low-back pain. NSAIDs are used with much greater frequency than oral skeletal muscle relaxants (SMRs) or opioids in the treatment of acute MSDs. Unfortunately, remarkably little sound science guides the choice of drug for the treatment of acute, uncomplicated MSDs, and the evaluation of efficacy of one agent over another is complicated by numerous factors. Only a limited number of high-quality, randomized, controlled trials (RCTs) provide evidence of the effectiveness of NSAIDs or SMRs in the treatment of acute, uncomplicated MSDs. The quality of design, execution, and reporting of trials for the treatment of MSDs needs to be improved. The combination of an SMR and an NSAID or COX-2 inhibitor or the combination of SMR and tramadol/acetaminophen is superior to single agents alone.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15767833&query_hl=2

Postoperative analgesic requirements - total laparoscopic hysterectomy versus vaginal hysterectomy.

Nascimento MC, Kelley A, Martitsch C, Weidner I, Obermair A.

Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

BACKGROUND: There is limited information available on the requirement for postoperative analgesic drugs in patients submitted to total laparoscopic hysterectomy (TLH) compared with patients undergoing vaginal hysterectomy (VH). AIM: To compare the postoperative analgesic requirements in patients who underwent a TLH with patients who had a VH. METHODS: Chart review of 53 patients who had TLH and 47 who had VH and were seen postoperatively by an acute pain management service in order to assess postoperative analgesic requirements. Patient controlled analgesia (PCA) was part of the standard protocol for postoperative pain management. Analgesic requirement was recorded as the mean doses of morphine and number of days that patients used non-steroidal anti-inflammatory drugs (NSAIDs), oxycodone and tramadol. RESULTS: The requirement for total morphine was approximately half the dose in patients who had a TLH (10.8 +/- 12.6 mg) compared with patients who had a VH (19.4 +/- 21.9 mg) (P 0.017). The length of use of NSAIDs was significantly reduced in patients who had undergone a TLH (2.0 +/- 0.95 days) as compared with patients who had a VH (2.85 +/- 1.1 days) (P < 0.0001). CONCLUSIONS: Patients submitted to TLH require less postoperative analgesic drugs when compared with patients who had VH. Prospective randomised trials are warranted to compare analgesic requirements between patients submitted to TLH and VH.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15760316&query_hl=2

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