Abstract piece taking from "McQuay H, Edwards J. Meta-analysis of single dose oral tramadol plus acetaminophen in acute postoperative pain. Eur J Anaesthesiol. 2003;20 Suppl 28:19-22.

Edwards, J

McQuay, H

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PRODUCT NEWSSouthern African Journal of Anaesthesia & Analgesia - May 2004 24nous odansetron to help relieve nausea and vomiting wassignificantly less in patients taking VIOXX, an approxi-mate 57 percent reduction, compared to those taking pla-cebo (18 percent versus 41 percent, p=0.04).• Flexing of the Replaced Knee: The ability to flex the re-placed knee following surgery, an important measure ofoutcome, also was greater in patients receiving VIOXX.For example, 67 degrees of flexion is needed to walk, 83degrees to climb stairs, 90 degrees to descend stairs, 93degree to rise from a chair and a full range of 106 degreesis required to tie one’s shoes.  At discharge from the hospi-tal, patients taking VIOXX demonstrated greater knee func-tionality compared to those taking placebo (mean 84.2 de-grees for patients receiving VIOXX versus 73.2 degreesfor those receiving placebo, p=0.03).  In addition, patientstaking VIOXX demonstrated an earlier achievement of 90degrees of flexion compared to placebo (p=0.05) and hada greater range of motion at one month (mean 109.3 de-grees for patients receiving VIOXX versus 100.8 degreesfor those receiving placebo, p=0.01) at just one month post-operation.Patients reported satisfaction with the level of painrelief provided by VIOXXPatient satisfaction also was assessed in the study, using a five-point scale where one represented “no efficacy” and five rep-resented “excellent efficacy.”  Overall, patients rated a highersatisfaction for VIOXX in terms of pain relief at dischargeversus placebo (4.3 versus 3.3, p=0.03).  The difference insatisfaction for VIOXX measured at discharge from the hos-pital persisted at two weeks and then again at a one-monthfollow-up.Reference1. Buvanendran A et al. Effects of Perioperative Administration of aSelective Cyclooxygenase 2 Inhibitor on Pain Management andRecovery of Function After Knee Replacement. JAMA2003;190:2411-2418.Combination proves effective for acute post-operative pain - A meta-analysis of single dose oral tramadoladministered in combination with acetaminophen (paracetamol)effect that is greater than either individual component. Thecombination formulation also had significantly lower  NNT(number-needed-to-treat) than the components alone, compa-rable to ibuprofen (400mg), the gold standard for this painmodel.Tramadol alone and acetaminophen (paracetamol) alone hadNNT of about 12 and 8, respectively. However, the combina-tion of tramadol and acetaminophen had a much improvedNNT of just under 3.ConclusionsThe meta-analysis demonstrated the analgesic superiority ofthe combination treatment over its components, without addi-tional toxicity. This is difficult to establish in individual con-ventional small size trials. “Combination analgesic formula-tions are an important and effective means of pain relief, andshould prove useful in treating elderly and other groups ofpatients who often cannot tolerate non-steroidal anti-inflam-matory drugs, including the newer COX-2 inhibitors,” thestudy concluded.ReferenceMcQuay H, Edwards J. Meta-analysis of single dose oral tramadol plusacetaminophen in acute postoperative pain. Eur J Anaesthesiol.2003;20 Suppl 28:19-22.Results from a recent meta-analysis published in the Euro-pean Journal of Anaesthesiology, showed the increased effi-cacy of the combination of tramadol with acetaminophen(paracetamol) for the treatment of acute post-operative pain.The meta-analysis was done at the Oxford Pain Relief Unitat the University of Oxford in the United Kingdom.MethodsIndividual patient data from seven randomised, double blindplacebo-controlled trails of tramadol plus acetaminophen(paracetamol) were used for analysis. All trials used identicalmethods and assessed single-dose oral tramadol (75 or112.5mg) plus acetaminophen (650 or 975mg) in adult dental(1376) or gynaecological/orthopaedic (407) patients withmoderate to severe pain. Summed pain intensity and pain re-lief data were extracted. Global evaluation by the patient wasscored on a five point scale: poor, fair, good, very good, orexcellent.ResultsThe results of the meta-analysis confirmed that the tramadol/acetaminophen combination is more effective than either ofits two components administered alone. The small dose oftramadol administered alone does not have much effect, butin combination with acetaminophen (paracetamol) it has an

Combination proves effective for acute postoperative pain - a meta-analysis of single dose oral tramadol administered in combination with acetaminophen (paracetamol): product news

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Combination proves effective for acute postoperative pain - a meta-analysis of single dose oral tramadol administered in combination with acetaminophen (paracetamol): product news

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