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  When examining the biological basis of drug addition, one must first understand the pathways in which drugs act and how drugs can alter those pathways. The Date review completed: 1995 Number of trials included: 18 Number of patients: 3453 (1486 tramadol / 695 placebo) Control group: oral placebo Main outcomes: pain relief at 6 hours (TOTPAR), Number-needed-to-treat (NNT) (with 95% confidence intervals) and relative benefit (with 95% confidence intervals). Inclusion criteria were single oral dose, randomised, placebo-controlled, double-blind trials of tramadol in acute postoperative pain with sufficient data to calculate the area under the curve for pain relief (TOTPAR). Baseline pain was moderate to severe. The 6 hour TOTPAR was calculated for each patient, and the data were converted to the percent of maximum total pain relief from categorical pain scales (%maxTOTPAR), and then to dichotomous information to generate a number-needed-to-treat for at least 50% pain relief. Relative benefit was calculated to provide an assessment of how much more likely an individual given a particular treatment is to have at least 50% pain relief than someone given no treatment. Adverse effects frequency data were used to calculate numbers-needed-to-harm and relative risk.
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  Best of the Web $85.00 American Society of Health-System Pharmacists, Inc. Disclaimer The MedMaster™ Patient Drug Information database provides information copyrighted by the American Society of Health-System Pharmacists, Inc., Bethesda, Maryland Copyright© 2007. All Rights Reserved. PMID 10959067. Diabetes Drug May Up Elderly Heart Risks This medicine contains the active ingredient tramadol hydrochloride, which is a type of medicine called an opioid analgesic or painkiller. Opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors. Tramadol mimics the action of our natural endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain. Therefore, even though the cause of the pain may remain, less pain is actually felt. Tramadol also works by enhancing the activity of neurotransmitters in the brain and spinal cord. Neurotransmitters are chemical compounds that act as chemical messengers between the nerve cells. Tramadol enhances the effect of the neurotransmitters serotonin and noradrenaline, and this action also helps relieve pain.
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