- Surgical patients who received tramadol alone for postoperative pain were 47% more likely to develop persistent opioid use and 41% more likely to become chronic opioid users compared with patients who received other short-acting opioids.
Why this matters
- Tramadol, which is scheduled at a lower risk level than hydrocodone or oxycodone, has seen a surge in usage in recent years for postoperative pain and currently is one of the most commonly prescribed opioids in the U.S.
- The authors suggest the FDA should consider rescheduling tramadol to a higher risk level.
- Study of 444,764 opioid-naive patients who underwent elective surgery.
- Funding: Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.
- 3.0% of patients received tramadol alone and 74.9% received ≥1 short-acting opioid other than tramadol.
- Receipt of tramadol alone at discharge vs other short-acting opioids was associated with a higher risk for:
- additional opioid use (adjusted risk ratio [aRR], 1.06; P=.049),
- persistent opioid use (aRR, 1.47; P<.001 and>
- chronic opioid use (aRR, 1.41; P=.013).
- Observational study.
Coauthored with Antara Ghosh, PhD