Comparative Trials
Tramadol versus Morphine
STUDY OBJECTIVE:
Tramadol and morphine were compared both for the treatment of pancreatitis pain and for their interaction with gut motor function.
DESIGN:
This was a double-blind randomized study.
PATIENTS:
25 patients suffering severe or chronic pancreatitis pain.
INTERVENTIONS:
Oral doses of Tramadol or morphine were gradually increased or decreased for five days, and the level of pain, the nature of any adverse side-effects, and the performance of the bowels as seen in orocecal and colonic transit times and the anal resting pressure were measured. The volume and pressure values were also monitored to determine rectal distension thresholds.
RESULTS:
Pain intensities (mean+/-SD, 0 = none, 100 = unbearable) before treatment and on day 4 were
- 75+/-19 and 8+/-13 with Tramadol (P < 0.001),
- 65+/-21 and 5+/-6 with morphine (P < 0.001).
On day 4, 67% of patients using Tramadol and 20% using morphine rated their pain management as excellent (P < 0.001) with average dosages of 840 mg (range: 80-1920) and 238 mg (range: 20-1125).
After five days of using Tramadol, orocecal transit was unchanged, but with morphine, it increased (P < 0.05). By day 5, more patients had extended colonic transit times with morphine (P < 0.05).The values for volume and pressure increased for rectal distension with Tramadol (P < 0.01). |
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CONCLUSION:
The study finds that both Tramadol and morphine have significant pain management capacity in cases of severe or chronic pancreatitis pain. This assumes patient-centred dosages adjusted to individual body mass and subjective need. Tramadol also had a lower impact on gut motor function and patients were more likely to rate as it as excellent as against morphine.
