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Pain management in dental practice: tramadol vs. codeine combinations
1Department of Public Health Dentistry, University of Pittsburgh School of Dental Medicine, Pa. 15261, USA.
Journal of the American Dental Association (1939)
|July 28, 1999
Summary
Tramadol offers pain relief comparable to codeine but is less effective than NSAIDs for acute dental pain. Its use is limited due to potential risks like seizures and abuse.
Area of Science:
- Pharmacology
- Pain Management
- Dental Therapeutics
Background:
- Tramadol hydrochloride is a centrally acting analgesic with dual opioid and aminergic mechanisms.
- Marketed since 1994, it's commonly used for chronic pain management.
- This review assesses its utility for acute dental pain.
Purpose of the Study:
- Evaluate the analgesic efficacy of tramadol in dentistry.
- Determine the safety profile of tramadol based on clinical trials and postmarketing data.
Main Methods:
- Systematic review of clinical drug trials in medicine and dentistry.
- Evaluation of postmarketing surveillance studies and adverse event reports.
Main Results:
- Tramadol's efficacy for acute oral surgery pain is similar to 60mg codeine, but inferior to NSAIDs or codeine combination analgesics.
- Reported adverse events include seizures, drug abuse, and anaphylactoid reactions.
Conclusions:
- Tramadol has limited indications in dentistry, primarily as an alternative when NSAIDs or codeine combinations are contraindicated or not tolerated.
- Consideration of tramadol requires careful risk-benefit assessment due to potential adverse events.