Katz W A
University of Pennsylvania Health System, Presbyterian Medical Center, Philadelphia, USA.
Drugs. 1996;52 Suppl 3:39-47. doi: 10.2165/00003495-199600523-00007.
Tramadol is a centrally acting analgesic that has been shown to be effective in a variety of acute and chronic pain states. Unlike other centrally acting analgesics, it exerts a dual action by binding to the opioid receptor site in the central nervous system and by weakly inhibiting the reuptake of biogenic amines. Tramadol is rapidly and almost completely absorbed, with an onset of action occurring within 1 hour of oral administration. The recommended dosage is 50 to 100 mg every 4 to 6 hours; however, regular administration is an alternative, particularly for chronic pain states such as osteoarthritis, where the use of the recently developed sustained release formulation may represent an important advantage. Published studies specifically evaluating the use of tramadol in this disease support its effectiveness. Nausea, drowsiness, constipation, dizziness, and sweating have been reported in association with tramadol use. Nausea occurs early in the course of administration, and may be reduced by slowly titrating the dose of tramadol against response. Tramadol would appear to be particularly useful in the elderly population affected by osteoarthritis because, unlike nonsteroidal anti-inflammatory drugs, it does not aggravate hypertension or congestive heart failure, nor does it have the potential to cause peptic ulcer disease. Compared with narcotics, tramadol does not induce significant respiratory depression, constipation, or have significant abuse potential.
曲马多是一种中枢性镇痛药，已被证明在多种急慢性疼痛状态下均有效。与其他中枢性镇痛药不同，它通过与中枢神经系统中的阿片受体部位结合以及微弱地抑制生物胺的再摄取发挥双重作用。曲马多吸收迅速且几乎完全吸收，口服给药后1小时内起效。推荐剂量为每4至6小时50至100毫克；然而，规律给药是一种选择，特别是对于骨关节炎等慢性疼痛状态，使用最近开发的缓释制剂可能具有重要优势。专门评估曲马多在该疾病中使用的已发表研究支持其有效性。与曲马多使用相关的不良反应有恶心、嗜睡、便秘、头晕和出汗。恶心在给药过程早期出现，可通过根据反应缓慢滴定曲马多剂量来减轻。曲马多在受骨关节炎影响的老年人群中似乎特别有用，因为与非甾体抗炎药不同，它不会加重高血压或充血性心力衰竭，也没有引起消化性溃疡疾病的可能性。与麻醉药品相比，曲马多不会引起明显的呼吸抑制、便秘，也没有明显的滥用可能性。
