Risk of prolonged use with tramadol vs other opioids examined

Compared to other short-acting opioids, patients receiving tramadol may be at increased risk of prolonged use after surgery, according to a study published in The bmj.

To better understand the risk associated with the chronic use of tramadol, a team of Mayo Clinic researchers conducted an observational study using claim data, identifying 444,764 patients operated in the United States from January 1, 2009 to May 30, 2009. June 2018. Of these patients, 357,884 opioid prescriptions were performed following surgery; Hydrocodone was the most commonly prescribed drug (53.0%), followed by oxycodone (37.5%) and tramadol (4.0%).

The study results showed that 7.1% of patients had had at least one refill of their opioid prescription 90 to 180 days after surgery (defined as an additional use), while 1% had renewed their prescription 180 to 270 days after surgery (defined as persistent use). . In addition, 0.46% of patients were classified as long-term users (consortium to study opioid risks and trends). [CONSORT] definition: ≥ 10 opioid refills or supply ≥120 days).

"Administration of tramadol alone has been associated with a 6% increase in the risk of additional opioid use compared to individuals receiving other short-acting opioids (95% CI incidence rate). % between 1.00 and 1.13; P = 0.049), 47% increase in adjusted risk of persistent opioid use (1.25 to 1.69, 0.5 percentage point; P <0.001) and a 41% increase in the adjusted risk of an episode of chronic use of opioid CONSORT (1.08 to 1.75, 0.2 percentage point; P = .013), "the authors reported.

Tramadol is currently classified as a Schedule IV controlled substance because it is considered to have a lower potential for abuse than Table II opioids. "Since tramadol is not as regulated as other short-acting opioids, these results deserve to be examined," said the lead author. Cornelius Thiels, DO, resident in general surgery at the Mayo Clinic School.

For more information, visit bmj.com.