title: Tramadol, an alternative to morphine for treating posttraumatic pain in the prehospital situation.
abstract: In this randomized, double-blinded, parallel-group study, we compared the efficacy of tramadol and morphine administered IV for the management of pain in trauma patients in the prehospital situation. One-hundred-five patients were randomly allocated to receive tramadol (Group T) or morphine (Group M). The initial dose was 100 mg tramadol in Group T and 5 mg morphine (body weight < or = 70 kg) or 10 mg morphine (body weight >70 kg) in Group M; this could be increased to 200 mg in Group T and 15 or 20 mg in Group M if necessary. Pain intensity was assessed with four-point verbal rating scales. Sedation, physiologic data, and adverse events were also recorded. Analgesia was similar in both groups; the 95% confidence interval for the difference between the decrease in pain intensity observed with tramadol or morphine was -0.26 to 0.30, which was within the predefined equivalence range (-0.50 to 0.50). Neither sedation scores nor physiologic data differed between groups. Tramadol is an acceptable alternative to morphine in the prehospital trauma setting.
authors.affiliation: Emergency Department, CHR de la Citadelle, Liege, Belgium. michel.vergnion@chrcitadelle.be
authors.forename: M
authors.initials: M
authors.lastname: Vergnion
authors.forename: S
authors.initials: S
authors.lastname: Degesves
authors.forename: L
authors.initials: L
authors.lastname: Garcet
authors.forename: V
authors.initials: V
authors.lastname: Magotteaux
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004632:Emergency Medical Services; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use*; D009141:Musculoskeletal System / Q000293:injuries; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement / Q000187:drug effects; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D014147:Tramadol / Q000009:adverse effects / Q000627:therapeutic use*; D014947:Wounds and Injuries / Q000150:complications*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol; D009020:Morphine