ORIGINAL A RTICLE Improved Cancer Pain Treatment Using Combined Fentanyl-TTS and Tramadol

The aim of the study was to facilitate dose escalation of strong opioids. In this randomized open-label study the influence of tramadol on dose adjustment of trans- dermal fentanyl in advanced cancer pain control was prospec- tively evaluated. Seventy patients affected by intractable cancer disease with visual analog scale (VAS) score >3 were enrolled. Thirty-five patients were treated conventionally with increasing transdermal fentanyl dosage as required (group F) and 35 patients received oral tramadol added to their transdermal fentanyl before each increment of the transdermalopioiddosage(groupT).Paincontrolwasequally