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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2008 Marzo;74(3):63-8
Tramadol SR in arthrosic and neuropathic pain
Mariconti P., Collini R.
Anesthetics and Pain Therapy Service, Mangiagalli Polyclinic Foundation, IRCCS, Milan, Italy
Background. Chronic pain requires adequate treatment to control the severity of pain, allowing it to be well tolerated for the long term. Slow release formulations represent a useful method for the treatment of lasting pain because they allow for more simple pain management. The aim of this study was to verify the efficacy and tolerability of tramadol SR for the treatment of two of the most common kinds of chronic pain: arthrosic and neuropathic pain.
Methods. A total of 100 patients (32 M/68 F), with a mean age of 61 years (±12) with non-oncologic pain (71 with arthrosic pain and 29 with neuropathic pain) were enrolled in an open prospective study. In most cases, the SR formulation of tramadol was prescribed at a dose of 100-200 mg/day; the initial follow-up appointments were two to four weeks later, and then at monthly intervals.
Results. During the study, a good analgesic response was recorded in all patients, irrespective of the type of pain they suffered. In fact, the intensity of the pain decreased rapidly and clearly, from severe (mean+SD 7.66+1.6 on an 11 point numerical scale) to mild residual pain (70.5% less than the baseline; P<0.05 between the times, NS between the groups), with pain relief and sleep quality displaying parallel improvement. Thus, all parameters of efficacy improved in both groups of patients, with no clinically important differences between the responses of the subjects with arthrosis and those of the subjects with neuropathic pain (P<0.05 between the times, NS between groups). Patient compliance was high. The tolerability was excellent in 75% of the patients. In the remaining 25%, the side effects that appeared were modest, as demonstrated by the fact that the drug was suspended in just 10 cases.
Conclusion. These results confirm that the efficacy of tramadol in the treatment of neuropathic pain is also present in the SR formulation. The safety profile is reassuring, and, fundamentally, tramadol treatment only requires identification of the optimal dose without particular warnings or precautions.