Ketorolac, Oxymorphone, Tapentadol, and Tramadol

Vadivelu, Nalini; Chang, Daniel; Helander, Erik; Bordelon, Gregory J.; Kai, Alice M.; Kaye, Alan D.; Hsu, Dora I; Bang, Daniel; Julka, Inderjeet S.

doi:10.1016/j.anclin.2017.01.001

Cited by 33 publications

(41 citation statements)

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“…However, this finding needs to be evaluated in clinical settings. Tramadol on the other hand is related structurally to morphine and codeine (Vadivelu et al, 2017). Tramadol and its major metabolite (o-desmethyl tramadol) is an agonist at µ receptor (Vadivelu et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Tramadol on the other hand is related structurally to morphine and codeine (Vadivelu et al, 2017). Tramadol and its major metabolite (o-desmethyl tramadol) is an agonist at µ receptor (Vadivelu et al, 2017). Tramadol also inhibits serotonin and norepinephrine reuptake concomitantly and these three mechanisms contribute to the pain control (Vadivelu et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Tramadol and its major metabolite (o-desmethyl tramadol) is an agonist at µ receptor (Vadivelu et al, 2017). Tramadol also inhibits serotonin and norepinephrine reuptake concomitantly and these three mechanisms contribute to the pain control (Vadivelu et al, 2017). At relatively large concentration, it is a NMDA (N-methyl D-aspartate) receptor antagonist, which can further contribute to its pain control (Vadivelu et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Peripheral noxious stimuli release glutamate which via the NMDA receptor may be responsible for hyperalgesia and neuropathic pain (Aiyer, Mehta, Gungor, & Gulati, 2018). So, despite being similar in structure to opioids, it differs mechanistically from opioids and has a distinct safety profile and is generally well-tolerated with low risk of addiction (Vadivelu et al, 2017). The analgesic activity of tramadol has been reported to be higher than diclofenac in other pain conditions e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Tramadol is a synthetic opioid (Gülen, Dur, Serinken, Karcıoğlu, & Sönmez, 2016). Although categorized as an opioid, tramadol also inhibits reuptake of serotonin and norepinephrine, which makes it a unique agent among opioids with good safety and tolerability profile (Vadivelu et al, 2017).…”

Section: Background and Objectivesmentioning

confidence: 99%

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Comparison of efficacy of diclofenac and tramadol in relieving pain in patients of acute pancreatitis: A randomized parallel group double blind active controlled pilot study

Kumar

Muktesh

Samra

et al. 2019

European Journal of Pain

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Background Opioids and non steroidal anti inflammatory drugs (NSAIDs) are commonly used for pain relief in acute pancreatitis (AP). Opioids carry risk of sphincter of oddi constriction. Although diclofenac prevents post endoscopic retrograde cholangio‐pancreatography (ERCP) pancreatitis, few reports of diclofenac associated AP are also present. Although, both tramadol and diclofenac are commonly used for pain relief in AP, no study has evaluated their comparative efficacy and safety. Materials and Methods Forty‐six eligible participants were randomized to either diclofenac or tramadol. Primary objectives of our study were improvement in pain intensity on visual analogue scale (VAS pain score after 1 hr of drug administration) and number of patients requiring supplementary analgesia. The secondary objectives were total number of times of supplementary analgesia requirement, time to significant decrease (33%) in VAS pain score from baseline, number of painful days (VAS pain score >5), VAS pain score on 7th day, side effects, all cause death and complications of pancreatitis between the two groups. Results Although 46 patients were randomized, the final analysis included 41 participants. Five patients were withdrawn from the study (intubation = 3, altered sensorium = 2). No significant difference was seen in terms of VAS score after 1 hr of drug administration, number of patients requiring supplementary analgesic and number of painful days. However, time taken to significant reduction of pain was lower in the diclofenac group (p = .028). Both the agents were comparable in terms of safety. Although complications were less in the diclofenac group, the difference was not statistically significant. Conclusion Both diclofenac and tramadol are equally effective in controlling pain in AP with similar safety profile. Significance There are no studies that have compared the safety and efficacy of two commonly used analgesics for pain relief in patients with AP. We found that both diclofenac and tramadol are equally effective in decreasing the pain associated with AP. There is also no significant difference in the incidence of side effects between both the groups. Hence both diclofenac and tramadol can be used safely and effectively for pain control in AP. Trial registration: The trial was registered with clinical trials registry India (Number‐ CTRI/2018/05/014309).

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Section: Discussionmentioning

confidence: 99%