title: Tramadol: new preparation. Capsules: central analgesic; step 2 on the WHO scale.
abstract: The clinical assessment file on tramadol is of low quality.  In acute postoperative pain and chronic pain there is no proof that tramadol has a better risk-benefit ratio than the paracetamol + codeine combination or other step 2 analgesics in the World Health Organisation classification.  Like all other central analgesics, tramadol can have neuropsychological adverse effects, especially a risk of dependence and misuse.
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003061:Codeine / Q000627:therapeutic use; D011431:Dextropropoxyphene / Q000627:therapeutic use; D004311:Double-Blind Method; D005602:France; D006801:Humans; D015201:Meta-Analysis as Topic; D009020:Morphine / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy*; D010349:Patient Compliance; D019966:Substance-Related Disorders / Q000209:etiology; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use; D016896:Treatment Outcome; D014944:World Health Organization
chemical_list: D000701:Analgesics, Opioid; D000082:Acetaminophen; D014147:Tramadol; D009020:Morphine; D011431:Dextropropoxyphene; D003061:Codeine