CONSENSUS RECOMMENDATION Miller et al. (2017) conducted a prospective cohort study to compare the effectiveness of opioids (i.e., hydrocodone, codeine, oxycodone) and tramadol. The results showed that patients that took opioids postoperatively had more medication-related side-effects and pill-consumption than those who took Tramadol. A multivariate regression analysis demonstrated that a tramadol prescription was an independent predictor of decreased total pill consumption. Moreover, patients with opioid prescriptions consumed only 28% of the filled prescription, compared to 36% consumption for tramadol. As this is the only article that met inclusion criteria and was low-quality due to its observational study design, the workgroup has provided the opinion consensus statement above.
Benefits/Harms of Implementation
The use of Tramadol over opioids for postoperative pain management has benefits as it avoids the many adverse effects of opioids (overdose and addiction).
Outcome Importance
Tramadol remains an option to help control postoperative pain.
Acceptability
Accepted treatment for pain in the postoperative state.
Future Research
There are no high-quality studies comparing the use of tramadol versus opioids in the control of postoperative pain after carpal tunnel release.