title: Does Tramadol Have a Role in Pain Control in Palliative Care?
abstract: BACKGROUND
  The effectiveness of the step II of the World Health Organization analgesic ladder including tramadol has been questioned recently.
  
  
  METHODS
  Retrospective study of patients treated with tramadol admitted as inpatients to one palliative care unit between November 1, 2009, and October 30, 2012.
  
  
  RESULTS
  In the study period, 730 patients were admitted and 66 (9%) of them met the criteria for inclusion; 45 (68%) continued medication with tramadol until discharge from the unit, while 21 (32%) had to switch to an opioid for moderate to severe pain. The reason for switching was uncontrolled pain in 16 (76%) patients, and for 5 (24%) patients, the switch was made for other reasons.
  
  
  CONCLUSIONS
  The data suggest that tramadol may have a role to play in the treatment of pain in palliative care.
authors.affiliation: Palliative Care, Portuguese Institute of Oncology, Porto, Portugal ferrazg@ipoporto.min-saude.pt.
authors.forename: José António Ferraz
authors.initials: JA
authors.lastname: Gonçalves
authors.affiliation: Palliative Care, Portuguese Institute of Oncology, Porto, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Silva
authors.affiliation: USF Navegantes, Póvoa de Varzim/Vila do Conde, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Araújo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D014147:Tramadol / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol
keywords: analgesic ladder; opioids for mild to moderate pain; pain; pain control; palliative care; tramadol