Tramadol versus acetaminophen/codeine for acute musculoskeletal pain

This 5-day, double-blind study compared tramadol 50 mg vs APAP/ codeine 300 mg/30 mg for acute musculoskelelal pain in ambulatory patients. For the first dose only, patients were given either 1 capsule (low dose) or 2 capsules thigh dose) of study medication. Thereafter, patients took medication as needed(1-2 caps q4-6 hours). Rescue medication was not permitted. Patients rated pain intensity and relief (both scales, 0 to 12) hourly for 6 hours after the first and second doses, and then daily. Sum of pain intensity differences (SPID), total pain relief (TOTPAR), and maximum pain relief (MAXPAR) were calculated. Patients and investigators provided global evaluation scores upon completion. Tramadol, in high (100 mg) or low (50 mg) initial doses, proved therapeutically equivalent to acetaminophen with codeine for acute pain from musculoskeletal injury.