We focused our attention on a fixed combination of tramadol 37.5 mg + paracetamol 325 mg, which could represent a useful approach to the management of FMS because of the combined, synergic analgesic effects of paracetamol on musculoskeletal pain and the serotoninergic activity of tramadol  on FMS-related.
Received Date: June 11, 2016; Accepted Date: September 19, 2016; Published Date: September 22, 2016.
In a similar way, the VAS score dropped from 8.1 ± 1.5 at Visit 1 to 5.5 ± 2.4 at Visit 2 (p<0.001), whilst the EPS decreased from 2.7 ± 0.8 to 2.0 ± 0.7 (p<0.001). No patient had still a very strong reaction to the touch of tender points and muscles, and most patients (50.0%) had an intermediate reaction ( Table 4 ).
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The general details of the 69 patients, who were visited for the first time at our sites, are given in ( Table 1 ).
Bij onvoldoende resultaat van een maximale dosis paracetamol en een NSAID kan een opioïd worden toegevoegd, in een dosering afgestemd op de individuele behoefte van de patiënt. Met een vaste combinatie van tramadol en paracetamol in een relatief lage dosering is deze individuele insling lastig. Daarom wordt.
Bij matige nierinsufficiëntie (creatinineklaring 10–30 ml/min) het interval verlengen naar 12 uur; ook bij matige leverinsufficiëntie verlenging van het interval overwegen.
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Ademhalingsdepressie, depressie van het centrale zenuwssel (van stupor tot coma), miosis, hypothermie, bradycardie, hypotensie en shock. Nierbeschadiging kan optreden, in zeldzame gevallen pancreatitis. Symptomen de eerste 24 uur vaak anorexie, misselijkheid, braken en malaise.
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Tramadol (Ultram) should be used with special caution because the non-observance of the dosage regimen and prolonged use of the high doses of analgetic may cause the following side effects: - deferred response.
- stomach upset (diarrhea, vomiting, stomachache) - tachycardia.
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Pain intensity may be high in the postoperative period after spinal vertebral surgery. The aim of the study was to compare the effectiveness and cost of patient controlled analgesia (PCA) with tramadol versus low dose tramadol-paracetamol on postoperative pain. A total of 60 patients were randomly divided into two groups.
A cost analysis for both groups was performed. The number of side effects, additional analgesic requirement and the total dose of tramadol were lower in Group P than in Group T. Pain intensity may be high in the postoperative period after spinal vertebral surgery. However, the total cost of postoperative analgesics was significantly higher in Group P than in Group T ( p < 0.001). The four-point nausea scale, numeric rating scale for pain assessment, Ramsey sedation scale, blood pressure, heart rate, respiration rate, peripheral oxygen saturation values and side effects were recorded at 0, 15 and 30 minutes, and at 1, 2, 4, 6, 12, 18 and 24 hours. In Group P, the numeric rating scale scores were significantly lower than that in Group T at 0 and 15 minutes. The time to reach an Aldrete score of 9 was also recorded. A total of 60 patients were randomly divided into two groups. The aim of the study was to compare the effectiveness and cost of patient controlled analgesia (PCA) with tramadol versus low dose tramadol-paracetamol on postoperative pain. The bolus and infusion programs were adjusted to administer a 1 mL bolus dose of tramadol with a lock time of 10 minutes. One group received 1.5 mg/kg tramadol (Group T) while the other group received 0.75 mg/kg tramadol plus 1 g of paracetamol (Group P) intravenously via a PCA device immediay after surgery and the patients were transferred to a recovery room, Tramadol was continuously infused at a rate of 0.5 mL/h in both groups, at a dose of 10 mg/mL in Group T and 5 mg/mL in Group P. In Group P, 1 g of paracetamol was injected intravenously every 6 hours. We conclude that PCA using tramadol-paracetamol could be used safely for postoperative pain relief after spinal vertebral surgery, although at a higher cost than with tramadol alone.