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Effect of Tramadol and Morphine on Pain and Gastrointestinal Motor Function in Patients with Chronic Pancreatitis

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Abstract

Tramadol and morphine were compared fortreatment of severe chronic pancreatitis pain and theirinteraction with gut motor function. Oral tramadol ormorphine doses were titrated double-blinded andrandomized for five days in 25 patients and pain, sideeffects, bowel function, orocecal and colonic transit,anal resting pressure, and rectal distension thresholdswere measured. Pain intensities (mean ± SD, 0 = none, 100 = unbearable) before treatment andon day 4 were 75 ± 19 and 8 ± 13 withtramadol (P < 0.001), and 65 ± 21 and 5± 6 with morphine (P < 0.001). On day 4, 67%of patients with tramadol and 20% with morphine rated their analgesia asexcellent (P < 0.001) with mean respective doses of840 mg (range: 80-1920) and 238 mg (20-1125). Orocecaltransit was unchanged after five days of tramadol, but increased with morphine (P < 0.05). Morepatients had prolonged colonic transit times withmorphine by day 5 (P < 0.05). Rectal distensionthreshold pressures increased only with tramadol (P < 0.01). It is concluded tramadol and morphineare potent analgesics in severe chronic pancreatitispain when individually titrated. Tramadol interferedsignificantly less with gastrointestinal function and was more often rated as an excellent analgesicthan morphine.

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Authors
  1. Clive H. Wilder-Smith
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  2. Lauren Hill
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  3. William Osler
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  4. Stephen O'Keefe
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Wilder-Smith, C.H., Hill, L., Osler, W. et al. Effect of Tramadol and Morphine on Pain and Gastrointestinal Motor Function in Patients with Chronic Pancreatitis. Dig Dis Sci 44, 1107–1116 (1999). https://doi.org/10.1023/A:1026607703352

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