Tramadol: new preparation. Capsules: central analgesic; step 2 on the WHO scale

The clinical assessment file on tramadol is of low quality. In acute postoperative pain and chronic pain there is no proof that tramadol has a better risk-benefit ratio than the paracetamol + codeine combination or other step 2 analgesics in the World Health Organisation classification. Like all other central analgesics, tramadol can have neuropsychological adverse effects, especially a risk of dependence and misuse.