A Pilot Study on the use of Tramadol Hydrochloride for Pain Control in an Emergency Department

Abstract

Tramadol hydrochloride is a synthetic µ-opioid agonist. It has been used in the control of moderate to severe pain. Most of the studies on tramadol were related to post-operative pain control. Data on acute pain control in the emergency setting were limited. This study reported on the initial evaluation of tramadol for pain control in an emergency department. Materials and methods: It was a prospective observational study. Patients aged 16 years or above attending our emergency department with moderate to severe pain were recruited. Patients with known allergy, current psychiatric medication, intake of alcohol, major systemic illness and opioid dependence were excluded. All patients received 100 mg intramuscular tramadol injection. A 10 cm Visual Analogue Scale (VAS) was used to assess the pain severity before injection, 30 minutes and 60 minutes after injection. Vital signs and side effects were also recorded. Results: Forty patients (M: 24, F: 16) were recruited from October to December 2002. Their mean age was 53.5 years. The majority of them suffered from acute musculoskeletal pain or arthritis. Tramadol was shown to be effective in pain control. The VAS decreased by 1.90 (p<0.001) and 3.38 (p<0.001) at 30 minutes and 60 minutes respectively. Four patients reported nausea and three patients vomited. Conclusion: Tramadol appeared to be a safe drug to be used in the emergency setting. Only a few insignificant side effects were reported. The comparison of efficacy with other analgesics requires further studies.

A Randomised Control Trial Comparing the Efficacy of Tramadol and Paracetamol against Ketorolac and Paracetamol in the Management of Musculoskeletal Pain in the Emergency Department

“…The reported incidence was about 1.6 to 6.1%. 4 Our study showed the incidence of side effects of the tramadol and paracetamol combination (48.7%) was higher than the ketorolac and paracetamol combination (43.6%), but it was not statistically significant. These minor effects were unexpectedly high compared to the reported incidence.…”

“…The sample size (n=34 in each group) was calculated with effect size 3.38. 4 The calculated standardised effect size was 0.8, with alpha 0.05 and power 0.90, we can look up in a table and find out the required sample size.…”

A Comparative Assessment of Postoperative Analgesic Efficacy of Lornoxicam versus Tramadol after Open Reduction and Internal Fixation of Mandibular Fractures

“…The reported incidence is $approximately 1.6 to 6.1%. 15 In the tramadol group, only two (10%) patients had an episode of nausea and vomiting during the first 2 hours postoperatively. These patients were administered a single dose of intravenous ondansetron stat, following which no further episode of vomiting was reported.…”

“…The common side effects associated with tramadol are nausea, dizziness, drowsiness, sweating, vomiting, and dry mouth. The reported incidence is ~approximately 1.6 to 6.1% 15. In the tramadol group, only two (10%) patients had an episode of nausea and vomiting during the first 2 hours postoperatively.…”

Who are Prone to Develop Adverse Effects with Oral Tramadol? a Retrospective Cohort Study

“…The exact incidence rate is unknown as most local studies were focused on intramuscular tramadol. [9][10][11][12] This study aims to describe the rate of significant adverse effects that warrant discontinuation of oral tramadol and identify the risk factors predicting significant adverse effect after use of tramadol, so as to avoid the use of oral tramadol on those high-risk patients.…”