The prevalence of COP is 5% in German University dental practices, where current guidelines of COP treatment are followed incompletely, and patients with psychological disorders are usually not treated. Interdisciplinary practice principles should be encouraged.
The large effect of both anesthetics on all spinal motor responses, compared with the small effect on electroencephalography and middle-latency auditory evoked responses, assuming that they represent cortical modulation, may suggest that the suppression of motor responses to transcranial magnetic stimulation is largely due to submesencephalic effects.
Background and objective: The purpose of this trial was to compare the efficacy, safety and side effects of post-operative pain therapy using oral controlled release formulations of tramadol and oxycodone. Methods: In a prospective, randomized, double-blind investigation, we observed the postoperative course of 57 patients scheduled for orthopedic surgery. We assessed pain at rest and during exercise, vital signs and side effects using direct measuring and Numerical Rating Scales over a period of three post-operative days. We used chi-squared or Fisher's exact test for categorical variables and the Mann-Whitney U-tsst for numerical variables (p < 0.05). Results: Demographic medical data and pain levels did not differ between the two treatments. Parameters for vital signs remained stable. Nausea and emesis occurred significantly more frequently with tramadol (p = 0.011, p = 0.013). Despite insignificance, central effects such as sedation, insomnia, myoclonus or nightmares were more frequent with tramadol. During the post-operative period, dizziness and sedation were attenuated significantly in the tramadol group (p = 0.031, p = 0.015) as was dry mouth in the oxycodone group (p = 0.041). Conclusion: Our findings underline the efficacy of oral controlled release formulations of tramadol and oxycodone for post-operative pain therapy. Controlled release oxycodone was shown to cause less nausea and emesis than controlled release tramadol. Further investigation is needed in order to confirm these results.
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