title: A single subcutaneous dose of tramadol for mild to moderate musculoskeletal trauma in the emergency department.
abstract: BACKGROUND
  Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the perception of a single subcutaneous dose of 50 mg tramadol for pain management in patients with mild to moderate musculoskeletal trauma, likewise to appraise the perception of pain by subcutaneous injection.
  
  
  METHODS
  A total of 77 patients, who met inclusion criteria, received a single subcutaneous dose of tramadol. Pain control was evaluated based on the verbal numerical pain scale (0-10) at baseline, 20 and 60 minutes; similarly, pain perception was evaluated secondary to subcutaneous injection of the analgesic.
  
  
  RESULTS
  On admission, the average pain perceived by patients was 8; twenty minutes later, 89% of the patients reported five or less, and after sixty minutes, 94% had three or less on the verbal numerical pain scale. Of the patients, 88% reported pain perception by verbal numeric scale of 3 or less by injection of the drug, and 6.5% required a second analgesic for pain control. Two events with drug administration (soft tissue infection and mild abdominal rectus injection) were reported.
  
  
  CONCLUSIONS
  We conclude that a single subcutaneous dose of tramadol is a safe and effective option for the management of patients with mild to moderate pain and musculoskeletal disease in the emergency department.
authors.affiliation: Emergency Department, Clinica Las Vegas, Medellin, Colombia.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Cardozo
authors.affiliation: Emergency Department, Clinica Las Vegas, Medellin, Colombia.
authors.forename: Carlos
authors.initials: C
authors.lastname: Silva
authors.affiliation: Emergency Department, Clinica Las Vegas, Medellin, Colombia.
authors.forename: Luis
authors.initials: L
authors.lastname: Dominguez
authors.affiliation: Emergency Department, Clinica Las Vegas, Medellin, Colombia.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Botero
authors.affiliation: Emergency Department, Clinica Las Vegas, Medellin, Colombia.
authors.forename: Paulo
authors.initials: P
authors.lastname: Zambrano
authors.affiliation: Epidemiology Department, Universidad CES, Medellin, Colombia.
authors.forename: Jose
authors.initials: J
authors.lastname: Bareno
keywords: Acute pain; Analgesic routes; Emergency department; Subcutaneous; Tramadol