title: [Efficacy of tramadol/acetaminophen medication for central post-stroke pain].
abstract: OBJECTIVE
  Central post-stroke pain(CPSP)is the most difficult type of central neuropathic pain to control with medical treatment. Opioids are commonly used for chronic neuropathic pain, but their efficacy in treating central neuropathic pain, particularly CPSP, is not clear. Tramadol is an opioid analgesic that, in combination with acetaminophen, has been approved since 2011 for the treatment of non-cancer pain in Japan. In this study we evaluated the efficacy of tramadol/acetaminophen medication for CPSP.
  
  
  METHODS
  We retrospectively reviewed nine cases of CPSP that received oral tramadol/acetaminophen medication. All cases received tramadol/acetaminophen medication after first taking pregabalin then antidepressant medication. Pain levels were assessed before tramadol/acetaminophen medication began and one month after a maintenance dose was reached, using a visual analogue scale(VAS)and the McGill pain questionnaire(MPQ).
  
  
  RESULTS
  The mean dose of tramadol was 121±61.6 mg/day. Tramadol/acetaminophen medication was effective in reducing pain in seven of nine cases(77.8%). The VAS improved 32.9±13.8% from pre-to post-medication, and the MPQ improved from 15.4±9.1 pre-medication to 8.1±4.7 post-medication(p<0.05). These effects continued 9.3±4.5 months during follow up periods. Side effects were observed in six cases(one severe, one moderate, two mild, two transient), but medication was continued in eight cases.
  
  
  CONCLUSIONS
  Oral tramadol/acetaminophen medication was effective at reducing pain levels in patients with CPSP, and is a medication option for the treatment of CPSP.
authors.affiliation: Department of Neurosurgery, Nagoya Central Hospital.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tanei
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Kajita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Noda
authors.forename: Shigenori
authors.initials: S
authors.lastname: Takebayashi
authors.forename: Masaki
authors.initials: M
authors.lastname: Hirano
authors.forename: Norimoto
authors.initials: N
authors.lastname: Nakahara
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Wakabayashi
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement / Q000379:methods; D020521:Stroke / Q000150:complications / Q000188:drug therapy*; D014147:Tramadol / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000082:Acetaminophen; D014147:Tramadol