Tramadol: does it have a role in emergency medicine?
Tramadol is a synthetic analgesic new to the Australasian market where its use is rapidly increasing. It is used extensively overseas, particularly in Europe where it has been popular since its introduction in Germany in the late 1970s. Tramadol has a dual mechanism of action: weak mu opioid receptor agonist and a reuptake inhibitor of serotonin and noradrenaline. Thus, it has distinct advantages and disadvantages compared to other available analgesics. Its use is advocated in a variety of acute and chronic pain states as well as some non-analgesic applications. The use of tramadol in an emergency setting is not well studied, with most published trials assessing its efficacy and tolerability in postoperative or dental models. This literature review concludes that tramadol does not offer any particular benefits over existing analgesics for the majority of emergency pain relief situations.
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Benjamin R
BR
Emergency Department, The Townsville Hospital, PO Box 670, Townsville, Queensland 4810, Australia. benclose74@yahoo.com
D015746:Abdominal Pain / Q000188:drug therapy; D000328:Adult; D000701:Analgesics, Opioid / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D001168:Arthritis / Q000150:complications; D001416:Back Pain / Q000188:drug therapy; D002637:Chest Pain / Q000188:drug therapy; D002648:Child; D002908:Chronic Disease; D003248:Constipation / Q000139:chemically induced; D004244:Dizziness / Q000139:chemically induced; D004304:Dosage Forms; D016527:Drug Costs; D004347:Drug Interactions; D062787:Drug Overdose / Q000175:diagnosis / Q000628:therapy; D004635:Emergency Medicine / Q000379:methods*; D006261:Headache / Q000188:drug therapy; D006801:Humans; D009140:Musculoskeletal Diseases / Q000150:complications; D009325:Nausea / Q000139:chemically induced; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D014076:Tooth Diseases / Q000150:complications; D014147:Tramadol / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D014839:Vomiting / Q000139:chemically induced
D000701:Analgesics, Opioid; D004304:Dosage Forms; D014147:Tramadol