Opioid vs. placebo in chronic pain

Tramadol may not provide significant benefit in managing chronic pain.

In a systematic review and meta-analysis published in BMJ Evidence-Based Medicine, investigators examined the safety and efficacy of the opioid tramadol compared with placebo among more than 6,500 patients with chronic pain who participated in 19 studies across the Cochrane Library, MEDLINE, Embase, Science Citation Index and BIOSIS databases.

The investigators found that although tramadol demonstrated positive effects compared with placebo, the small effect size indicated a low certainty that the drug’s benefits may be limited. Additionally, compared with placebo, tramadol resulted in a greater rate of serious and nonserious adverse effects such as cardiac events, neoplasms, nausea, dizziness, constipation and somnolence.

As a result of the findings, the investigators concluded that the risks of tramadol use could outweigh its slight benefits.

Read more: BMJ Evidence-Based Medicine

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