Tramadol in the treatment of neuropathic cancer pain: a double-blind, placebo-controlled study.
OBJECTIVE
To assess the efficacy, safety and impact on quality of life of tramadol in the treatment of neuropathic pain in patients with cancer.


METHODS
Patients with similar characteristics were grouped in pairs and randomised to receive either tramadol or placebo. The initial tramadol dosage was 1 mg/kg every 6 hours, increasing to 1.5 mg/kg every 6 hours if necessary to control pain.


RESULTS
The study enrolled 36 patients (22 women, 14 men), with a mean age of 50 years. In the group receiving tramadol (n = 18), major improvements in pain intensity and Karnofsky scores occurred (p < 0.001), sleep quality improved by day 45 (p < 0.05) activities of daily living improved (p < 0.05), and use of analgesics that had been taken before the study was reduced (p < 0.05) compared with the placebo group. There was no difference between the groups with regard to changes in the Zung Depression Scale, Beck Anxiety Inventory scores and neurophysiological assessments. More patients in the tramadol group experienced adverse events (p < 0.05). The most common adverse events were nausea, vomiting and constipation.


CONCLUSIONS
Tramadol is a therapeutic option for the control of neuropathic pain in patients with cancer, and appears to improve quality of life in these patients. The analgesic effect of tramadol is independent of changes in anxiety, depression and nervous system function.
Arbaiza
Daniel
D
Service of Neuro-Oncology, National Cancer Institute, Lima, Peru. darbaiza@inen.sld.pe
Vidal
Oscar
O
D000203:Activities of Daily Living; D000284:Administration, Oral; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001066:Appetite / Q000187:drug effects; D003248:Constipation / Q000139:chemically induced; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D012890:Sleep / Q000187:drug effects; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
D000701:Analgesics, Opioid; D014147:Tramadol