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REGIONAL ANESTHESIA

Tramadol, an Alternative to Morphine for Treating Posttraumatic Pain in the Prehospital Situation

Emergency Department and Department of Anesthesiology, CHR de la Citadelle, Liege, Belgium

Address correspondence and reprint requests to Vergnion Michel, Service des Urgences, Bd du 12ème de Ligne, 4000 Liège, Belgium. Address e-mail to michel.vergnion{at}chrcitadelle.be

Abstract

In this randomized, double-blinded, parallel-group study, we compared the efficacy of tramadol and morphine administered IV for the management of pain in trauma patients in the prehospital situation. One-hundred-five patients were randomly allocated to receive tramadol (Group T) or morphine (Group M). The initial dose was 100 mg tramadol in Group T and 5 mg morphine (body weight 70 kg) or 10 mg morphine (body weight >70 kg) in Group M; this could be increased to 200 mg in Group T and 15 or 20 mg in Group M if necessary. Pain intensity was assessed with four-point verbal rating scales. Sedation, physiologic data, and adverse events were also recorded. Analgesia was similar in both groups; the 95% confidence interval for the difference between the decrease in pain intensity observed with tramadol or morphine was -0.26 to 0.30, which was within the predefined equivalence range (-0.50 to 0.50). Neither sedation scores nor physiologic data differed between groups. Tramadol is an acceptable alternative to morphine in the prehospital trauma setting.

Implications: We demonstrated an equivalent efficacy and safety of IV tramadol and morphine in the management of pain in the prehospital trauma setting. Because tramadol is not a narcotic drug, its use would allow emergency medical systems to avoid the inconvenience of transporting controlled substances.

This article has been cited by other articles:

				W. T. Zempsky, J. P. Cravero, and Committee on Pediatric Emergency Medicine, and Sec Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems Pediatrics, November 1, 2004; 114(5): 1348 - 1356. [Abstract] [Full Text] [PDF]