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Tramadol for neuropathic pain
J Hollingshead1, R M Dühmke, D R Cornblath
1Royal Sussex County Hospital, Eastern Road, Brighton, UK BN2 5BE. james@hollo.org
The Cochrane Database of Systematic Reviews
|July 21, 2006
Summary
Tramadol effectively reduces neuropathic pain, with a number needed to treat of 3.8 for significant pain relief compared to placebo. This systematic review confirms tramadol
Area of Science:
- Neurology
- Pharmacology
- Pain Management
Background:
- Peripheral neuropathic pain presents with diverse symptoms like burning sensations and heightened sensitivity to stimuli.
- It is a prevalent symptom across various peripheral nervous system disorders.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) evaluating the efficacy of tramadol for neuropathic pain.
- To assess tramadol's effectiveness against placebo and other analgesics.
Main Methods:
- Searched multiple databases (Cochrane, MEDLINE, EMBASE, LILACS) up to June 2005 for RCTs and quasi-RCTs.
- Included trials comparing tramadol with placebo, other treatments, or no treatment for neuropathic pain.
- Extracted data, scored quality, and performed meta-analysis for effectiveness and adverse effects.
Main Results:
- Four placebo-controlled trials indicated tramadol significantly reduced neuropathic pain.
- Meta-analysis of three trials (269 participants) showed a number needed to treat (NNT) of 3.8 for at least 50% pain relief.
- Tramadol demonstrated efficacy in reducing paresthesia, allodynia, and touch-evoked pain.
- Number needed to harm (NNH) for treatment withdrawal due to side effects was 8.3.
Conclusions:
- Tramadol is established as an effective pharmacological intervention for neuropathic pain.
- Evidence supports tramadol's use for specific neuropathic pain symptoms.
- Further research is needed to compare tramadol with other analgesics like clomipramine and morphine.