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Efficacy of Tramadol/Acetaminophen Medication for Central Post-Stroke Pain Takafumi TANEI 1 , Yasukazu KAJITA 2 , Hiroshi NODA 3 , Shigenori TAKEBAYASHI 1 , Masaki HIRANO 1 , Norimoto NAKAHARA 1 , Toshihiko WAKABAYASHI 2 1Department of Neurosurgery, Nagoya Central Hospital 2Department of Neurosurgery, Nagoya University Graduate School of Medicine 3Department of Neurosurgery, Kasugai Municipal Hospital Keyword: tramadol , central post-stroke pain , pregabalin , opioid , neuropathic pain pp.679-685
Published Date 2013/8/10
DOI https://doi.org/10.11477/mf.1436102051
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 Objective:Central post-stroke pain(CPSP)is the most difficult type of central neuropathic pain to control with medical treatment. Opioids are commonly used for chronic neuropathic pain, but their efficacy in treating central neuropathic pain, particularly CPSP, is not clear. Tramadol is an opioid analgesic that, in combination with acetaminophen, has been approved since 2011 for the treatment of non-cancer pain in Japan. In this study we evaluated the efficacy of tramadol/acetaminophen medication for CPSP.

 Methods:We retrospectively reviewed nine cases of CPSP that received oral tramadol/acetaminophen medication. All cases received tramadol/acetaminophen medication after first taking pregabalin then antidepressant medication. Pain levels were assessed before tramadol/acetaminophen medication began and one month after a maintenance dose was reached, using a visual analogue scale(VAS)and the McGill pain questionnaire(MPQ).

 Results:The mean dose of tramadol was 121±61.6 mg/day. Tramadol/acetaminophen medication was effective in reducing pain in seven of nine cases(77.8%). The VAS improved 32.9±13.8% from pre-to post-medication, and the MPQ improved from 15.4±9.1 pre-medication to 8.1±4.7 post-medication(p<0.05). These effects continued 9.3±4.5 months during follow up periods. Side effects were observed in six cases(one severe, one moderate, two mild, two transient), but medication was continued in eight cases.

 Conclusion:Oral tramadol/acetaminophen medication was effective at reducing pain levels in patients with CPSP, and is a medication option for the treatment of CPSP.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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