Revisiting Tramadol: A Multi-Modal Agent for Pain Management

Barakat, Ahmed

doi:10.1007/s40263-019-00623-5

Cited by 53 publications

(42 citation statements)

References 220 publications

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“…23 Its role has been established in the guidelines of treatment of neuropathic and somatic pain. [24][25][26] Although the efficacy of tramadol has not been studied specifically in HIV-related pain, tramadol is commonly prescribed for HIV-infected patients. 26 A recent review of tramadol highlighted its value in pain management in the countries with poor or restricted access to opioid analgesics.…”

Section: Discussionmentioning

confidence: 99%

Sustainability of Palliative Care in a Rural Hospital in Tanzania: A Longitudinal and Prospective 4-Year Study

et al. 2020

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Background: Palliative care has been developed in recent years in many sub-Saharan countries in Africa due to activities of African Association for Palliative Care. Palliative care units have been established also in most hospitals in Tanzania. Yet very little is known about their functions. Long-term studies about the sustainability of palliative care have not been carried out. Methods: The attitudes of 101 members of hospital staff and persons in charge of palliative care services of Ilembula District Designated Hospital (IDDH), Tanzania, were assessed using a modified and prevalidated questionnaire annually in 2014 to 2017. The inquiries were executed on randomly allocated days. Also, the patient and economy registries were analyzed. Additional qualitative data were obtained in personal interviews and during observational visits twice a year at the IDDH. Results: Ilembula District Designated Hospital has a true multiprofessional palliative care team, which provides services in the hospital, in the villages, and at homes. The activities are based on careful 5-year planning and budgeting. Up to 17 villages have been included in the services. Ninety-five percent of the patients were HIV infected. Short-acting morphine oral solution was the only available strong opioid. The hospital staff evaluated palliative care as good or excellent; 50% of the staff would need more support in the end-of-life care. Conclusions: A sustainable palliative care service can be built in a Tanzanian rural hospital if an advanced planning and budgeting are made. In Tanzania, the biggest group of palliative care patients are still HIV-infected individuals. There is a lack of opioids in the country.

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Section: Discussionmentioning

confidence: 99%

Sustainability of Palliative Care in a Rural Hospital in Tanzania: A Longitudinal and Prospective 4-Year Study

et al. 2020

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“…Preclinical studies suggested that tramadol potentiates the antinociceptive effects of several drugs including paracetamol, NSAIDs, ketamine, and alpha‐2 agonists. Systematic reviews and meta‐analyses of adult clinical studies supported the synergistic interactions between tramadol and other analgesics in clinical settings such as chronic and neuropathic pain conditions 21 …”

Section: Discussionmentioning

confidence: 99%

“…Systematic reviews and meta-analyses of adult clinical studies supported the synergistic interactions between tramadol and other analgesics in clinical settings such as chronic and neuropathic pain conditions. 21 Tramadol was included as a first-choice treatment among pediatric pain specialists for chronic pain in children and adolescents. 22 We prescribed tramadol for up to 4 weeks because its long-term safety and efficacy have only been studied for up to 30 days.…”

Section: Before Bisphosphonatesmentioning

confidence: 99%

Use of bisphosphonates in a retrospective case series of children and adolescents with complex regional pain syndrome

Walfish

Sbrocchi

Rivera

et al. 2021

Pediatric Anesthesia

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Background: There is increasing evidence for the use of bisphosphonates to treat Complex Regional Pain Syndrome in adults. However, there are scarce data for their use in children with Complex Regional Pain Syndrome.Aim: This retrospective case series aimed to analyze the effects of intravenous bisphosphonate use in children and adolescents with Complex Regional Pain Syndrome enrolled in a multidimensional pain treatment program. Methods:We analyzed the data of 16 patients (15 females and 1 male, mean age 14 ± 3 years) who received infusions of zoledronic acid (0.015 ± 0.0044mg/kg), pamidronate (0.72 ± 0.17mg/kg), or both depending on their initial response between October 2014 and December 2019. The primary endpoint of the study was the patient's global impression of change. Secondary outcomes included pain intensity, physical function, role function (school attendance), need for pain medications, and adverse effects.Results: Nine of 16 patients reported meaningful improvements (global impressions of change of 84% or higher) at a median follow-up time of 16 (8-21) months after their last infusion of bisphosphonates. There were also meaningful reductions in pain intensity and the need for pain medications. There was an increase in the proportion of patients with minimal or without physical disability, and almost all patients normalized their school activities. Thirteen patients (81%) reported adverse effects, mostly flu-like symptoms, for a few days after the infusion. Conclusion:The use of bisphosphonate infusions may represent an effective treatment option for children with Complex Regional Pain Syndrome, not responding to multidisciplinary pain treatment programs. K E Y W O R D Sadolescent, bisphosphonates, child, chronic pain, complex regional pain syndromes

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“…The involvement of the adrenergic system in pain modulation is expressed not only in NSAIDs, but also in opioids, for example, tapentadol is an analgesic drug with a dual mode of action: MOR agonist and noradrenaline reuptake inhibitor [20]. Similarly, tramadol, another opioid used in pain, shares an adrenergic pathway in its mechanism of action [21]. Additionally, it has been hypothesized that drugs capable of inducing the activation of the adrenergic system could exert their analgesic efficacy by inhibiting the activation of microglia [22].…”

Section: Discussionmentioning

confidence: 99%

Adrenergic modulation of dexketoprofen antinociception in murine formalin orofacial pain

Miranda¹,

Noriega²,

Sierralta³

et al. 2021

World J. Adv. Res. Rev.

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Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in pain whose mechanism of action is the inhibition of cyclooxygenase enzymes (COXs), however, there are evidence of other mechanisms of action, such as the inhibition of substance P, interaction with systems NO, monoaminergic and others. The objective of the present work was to study the participation of a-1 (prazosin) and a-2 (yohimbine) adrenoceptors antagonists in the antinociception of dexketoprofen, the S (+) enantiomer of ketoprofen. The antinociception evaluation was thru the mice orofacial formalin assay. Dexketoprofen (DEX) induced a dose-related antinociception 3.40 times more potent in phase I than in phase II. Prazosin i.p. decreased of the antinociception of DEX, 2.01 times in phase I and 4.02 times in phase II. Administered i.t. reduced the antinociception 5.30 times in phase I and 6.20 times in phase II. Yohimbine i.p. induced a reduction of the ED50 of 3.40 times in phase I and 4.50 times in phase II, after i.t. administration the reduction was 5.30 times in phase I and 6.20 times in phase II. The mechanism of antinociception induced by DEX is mediated by the activation of α-1 and α-2 adrenergic receptors at supraspinal and spinal levels.

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Revisiting Tramadol: A Multi-Modal Agent for Pain Management

Cited by 53 publications

References 220 publications

Sustainability of Palliative Care in a Rural Hospital in Tanzania: A Longitudinal and Prospective 4-Year Study

Sustainability of Palliative Care in a Rural Hospital in Tanzania: A Longitudinal and Prospective 4-Year Study

Use of bisphosphonates in a retrospective case series of children and adolescents with complex regional pain syndrome

Adrenergic modulation of dexketoprofen antinociception in murine formalin orofacial pain

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