Tramadol is indicated for relief of moderate to severe pain both acute and chronic in nature. Tramadol was compared with prolonged action morphine in patients with chronic cancer pain. Treatment was for 1-3 month with variable doses. Excellent or good results were obtained in 89% of patients with morphine. However side effects occurred in the morphine group necessitating drug withdrawal in 6/26 patients, respiratory depression was seen with morphine but not with tramadol. In another study, tramadol and pethidine were equally in controlling post-operative pain. It is well known that not all types of pain respond well to opioid analgesics. For example, cancer pain is opioid-sensitive and long term use of opioids is justifiable. In opioid-sensitive pain respiratory depression and addiction occur rarely. Long term use of tramadol in non-cancer pain is justified if the pain are pain due to nerve compression and destruction, trigeminal post-herpetic pain and central pain.
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