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Tramadol for neuropathic pain
The Cochrane Database of Systematic Reviews
|April 24, 2004
Summary
Tramadol effectively reduces neuropathic pain, offering significant relief compared to placebo. This systematic review confirms its efficacy, with a number needed to treat of 3.5 for substantial pain reduction.
Area of Science:
- Neurology
- Pharmacology
- Pain Management
Background:
- Neuropathic pain involves symptoms like burning or shooting sensations due to nerve damage.
- It is associated with various disorders, all sharing nerve damage as a common factor.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) on tramadol's efficacy for neuropathic pain.
- To evaluate tramadol's effectiveness against placebo and other analgesics.
Main Methods:
- Searched multiple databases (Cochrane, MEDLINE, EMBASE, LILACS) up to July 2002.
- Included randomized and quasi-randomized controlled trials comparing tramadol to placebo, other treatments, or no treatment.
- Extracted data, scored trial quality, and calculated relative risks and numbers needed to treat/harm.
Main Results:
- Three placebo-controlled trials showed tramadol significantly reduced neuropathic pain.
- Meta-analysis (161 participants) indicated a number needed to treat of 3.5 for 50% pain relief.
- Tramadol demonstrated efficacy in specific pain types like paresthesia and allodynia; number needed to harm was 7.7.
Conclusions:
- Tramadol is confirmed as an effective treatment for neuropathic pain.
- Evidence supports its use, particularly when compared to placebo.
- Further research is needed for comparisons with other analgesics like clomipramine and morphine.