Intramuscular tramadol versus ketorolac in patients with orthopedic and traumatologic postoperative pain: a comparative multicenter trial

This 3-day, multicenter, open-label, randomized, controlled trial was undertaken to assess the postoperative analgesic effect and therapeutic safety of intramuscular tramadol compared with intramuscular ketorolac in 48 patients undergoing orthopedic surgery and having postoperative pain assessed as 75 mm or more on a 100-mm visual analogue scale. Tramadol (100 mg/2 mL ampules) was administered as needed to a maximum of 400 mg/d, and ketorolac (30 mg/1 mL ampules) was given as needed up to 90 mg/d. Nine patients who received tramadol and six who received ketorolac needed only one dose of medication to achieve satisfactory analgesia. Tramadol had a more pronounced analgesic effect than did ketorolac. After 1 and 2 hours, respectively, 41.7% and 52.5% of the patients who received tramadol experienced relief, compared with 33.9% and 42.1% of the patients who received ketorolac. No adverse reactions were observed in either group, and the investigator's final opinion was positive (ie, effective analgesia in 19 patients [79.2%] who received tramadol and in 14 patients [58.3%] who received ketorolac). Intramuscular tramadol therefore appeared to be as effective as ketorolac against orthopedic postoperative pain and was well tolerated.