Comparison of three doses of oral ciramadol and placebo for the treatment of moderate to severe postoperative pain.

Ciramadol, 20, 40, or 60 mg, or a placebo was administered orally, double blind, to patients complaining of moderate (N = 89) or severe (N = 80) postoperative pain to determine the lowest effective dose. The highest dose used for moderate pain, 40 mg, was statistically more effective than placebo as measured by pain intensity differences and pain relief scores. The highest dose used to treat severe pain, 60 mg, was also more effective statistically than placebo and the lower doses of ciramadol at certain points during the 6-hour observation period. Drowsiness was minimal, and side effects were infrequent and mild in intensity. We conclude that 40 mg ciramadol for moderate postoperative pain and 60 mg ciramadol for severe postoperative pain would be the minimal oral doses to compare with standard analgesics in future studies.