tramadol/acetaminophen / Generic mfg. - LARVOL DELTA

PATTERNS AND IMPLICATIONS OF OPIOID USE IN PATIENTS WITH RHEUMATIC DISEASES (EULAR 2025) - "Finally, as third-line therapy, codeine-paracetamol combination was the most prescribed (60%), followed by tramadol-paracetamol (20%) and morphine (20%). Our study showed the high level of misusage of opioids among patients with RD. Factors associated with high use are the frequency of prescription over the last year, duration of prescription and diabetes. Early identification of misuse risk factors and prioritizing alternatives are crucial."

Clinical • Addiction (Opioid and Alcohol) • Ankylosing Spondylitis • Diabetes • Fatigue • Immunology • Inflammatory Arthritis • Metabolic Disorders • Musculoskeletal Pain • Pain • Rheumatoid Arthritis • Rheumatology • Seronegative Spondyloarthropathies • Spondylarthritis • Xerostomia

Evaluation of pharmacotherapy in sickle cell disease in an Afro- Colombian community: A cross-sectional analytical study in San Basilio de Palenque, Bolívar. (PubMed, Intractable Rare Dis Res) - "The most commonly used medications included folic acid, analgesics (paracetamol, tramadol, naproxen, codeine, ibuprofen, morphine), L-glutamine, and enalapril...Notably, 62% of homozygous patients were not receiving baseline treatment with hydroxycarbamide, increasing their risk of complications...In conclusion, this research highlights the need for a multidisciplinary approach to optimize treatment and improve the quality of life of affected patients. Given its genetic significance, San Basilio de Palenque represents a unique setting for further studies on SCD."

Journal • Genetic Disorders • Hematological Disorders • Pain • Sickle Cell Disease

Perioperative management of myotonic dystrophy: tailored approaches to general anaesthesia – a case report (Euroanaesthesia 2025) - "Anesthesia induction was performed with 2mg midazolam, 100mcg fentanyl, 200mg propofol, and 50mg rocuronium, followed by orotracheal intubation...Analgesia included 1g paracetamol, 100mg tramadol, and 30mg ketorolac...At the procedure's end, 400mg sugammadex were administered, achieving a TOF ratio >0.9...Hypersensitivity to sedatives and paralytics increases risks of ventilatory dysfunction, delayed muscle recovery, pharyngeal dysfunction, and aspiration. To mitigate these, short-acting drugs are recommended to allow rapid recovery of consciousness and muscle strength.2"

Case report • Clinical • Anesthesia • Cardiovascular • Cataract • Dysphonia • Gastrointestinal Disorder • Genetic Disorders • Immunology • Muscular Dystrophy • Myositis • Myotonic Dystrophy • Ophthalmology • Otorhinolaryngology • Pain • Pulmonary Disease

Postoperative neuropathic pain after knee arthroplasty: The role of transitional pain medicine (Euroanaesthesia 2025) - "He was prescribed gabapentin, alpha-lipoic acid supplement, tapentadol, tramadol+paracetamol combination, duloxetine, and metamizole, and referred to the Transition Pain Clinic. The patient was followed for 7 months, gradually reduced pain medication, and initiated physical therapy. Neuropathic pain symptoms were resolved at discharge. This case highlights the importance of early intervention and specialized care in managing postoperative neuropathic pain.2 This comprehensive approach led to a favorable outcome, emphasizing the tole of Transition Pain Medicine in contemporary pain management."

Anesthesia • Musculoskeletal Pain • Neuralgia • Orthopedics • Pain

Complex hernia repair with the Fasciotens® system under combined anesthesia (Euroanaesthesia 2025) - "A cephalically-oriented epidural catheter was inserted at the T11-T12 level, followed by rapid sequence intubation with Propofol 2mg/kg, Fentanyl 2µg/kg and Rocuronium 1.2mg/kg. The maintenance agent was Sevoflurane...Analgesia included Ketamine 20mg, Paracetamol 1g, Tramadol 100mg and 1mg Epidural Morphine...A switch from Ropivacaine to fixed Epidural Morphine 2.5mg 2x/d was conducted on day 2 due to hypotension...Postoperative pain can compromise the patient's respiratory function and rehabilitation, making locoregional techniques beneficial.Learning points: The Fasciotens® system can aid surgeons in correcting large hernias. The anaesthesiologist must be familiar with these tools in order to better adapt the perioperative anaesthetic plan for each patient."

Anesthesia • Gastroenterology • Hypotension • Pain

Multimodal general anesthesia with dexmedetomidine for endonasal surgery in paroxsysmal nocturnal hemoglobinuria (PNH): a case report (Euroanaesthesia 2025) - "Current medication included eculizumab, prednisolone and acenocumarol.Patient was monitored according to ASA standards plus invasive arterial pressure, ToFscan®, Sedline® and O3®. General anesthesia was induced with target-controlled infusion of remifentanil, lidocaine (1mg/kg), propofol and rocuronium, and maintained with sevoflurane and an infusion of dexmedetomidine (DEX) at 0.4mcg/Kg/h. Multimodal analgesia included also paracetamol and tramadol...We hypothesized that DEX could attenuate complement activation and reduce complications.Learning points: Anesthetic management of patients with PHN is complex. The use of DEX could be a safe alternative, by reducing surgical stress and possibly complement activation and hemolytic crisis."

Case report • Clinical • Surgery • Anesthesia • Cardiovascular • Hematological Disorders • Hepatology • Infectious Disease • Inflammation • Otorhinolaryngology • Portal Hypertension • Thrombocytopenia • Thrombosis

Regional anesthesia in colorectal laparoscopy: a retrospective comparison of quadratus lumborum and TAP blocks. (PubMed, J Med Life) - "Non-opioid usage (paracetamol, tramadol, nefopam) was similarly lower in Group B across all comparisons (P < 0.001). Group B also exhibited a significantly shorter hospital stay (4.87 ± 1.14 days) relative to Groups A and C. The QL block was associated with superior postoperative analgesia, reduced opioid and adjunct analgesic requirements, prolonged pain-free intervals, and accelerated postoperative recovery in laparoscopic colorectal surgery. These findings underscore QL block as a potent element of opioid-sparing, multimodal analgesic strategies and support its broader adoption in enhanced recovery protocols."

Clinical • Journal • Observational data • Retrospective data • Anesthesia • Pain

Unveiling the hidden pain and daily struggles of individuals with a venous leg ulcer: a thematic analysis. (PubMed, J Tissue Viability) - "VLU-associated pain is a prevalent and debilitating aspect of individuals' lives, impacting both physical and psychological health. Comprehensive pain management strategies that integrate both pharmacological and psychosocial approaches should be enhanced to improve patient outcomes."

Journal • Pain • Venous Ulcer

PREVENTION AND MANAGEMENT OF COMPLICATED ORAL MUCOSITIS IN CHILDREN RECEIVING HSCT: A CASE FROM PAEDIATRIC BONE MARROW TRANSPLANT CENTRE OF A.S.S.T. SPEDALI CIVILI DI BRESCIA (EBMT 2025) - "Significant oral pain subsequently appeared in the context of mucositis with refusal to eat, for which antalgic therapy with Paracetamol and Tramadol was undertaken...After discussion with the infectivologist, antiviral therapy with Acyclovir ev at 10 mg/kg every 8 hours and ozone therapy in the oral cavity was administered... This clinical case represents the multifactorial nature of mucositis affecting patients undergoing HSCT and the importance of treating each individual cause through a multidisciplinary approach. In this team, the nurse has a key role, as he/she is responsible for the systemic evaluation of the oral cavity using an appropriate scale and for detection of pain using a scale appropriate to patient's age and state of consciousness. He/she also guarantees the correct application of the mucositis prevention and treatment protocol and carries out educational interventions to parent and child."

Clinical • Bone Marrow Transplantation • Graft versus Host Disease • Immunology • Infectious Disease • Mucositis • Oncology • Pain • Pediatrics • Stomatitis • Transplantation

Psychotropic Drug Use in Korean Patients With Osteoarthritis. (PubMed, J Korean Med Sci) - "A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults."

Journal • CNS Disorders • Epilepsy • Immunology • Osteoarthritis • Pain • Psychiatry • Rheumatology

The incidence of hypersensitivity to non-steroid anti-inflammatory drugs in the group of patients with rheumatoid musculoskeletal disorders: the cross-sectional study. (PubMed, Rheumatol Int) - "Key risk factors for hypersensitivity included daily NSAID intake, asthma, chronic urticaria, smoking, aspirin use at cardiological doses, and a history of allergic reactions. Selective COX-2 inhibitors, paracetamol, or tramadol may be safer alternatives for patients at risk of hypersensitivity. Further studies are required to validate these findings in larger cohorts."

Journal • Observational data • Allergy • Ankylosing Spondylitis • Asthma • Cardiovascular • Dermatology • Immunology • Musculoskeletal Diseases • Musculoskeletal Pain • Osteoarthritis • Pain • Pulmonary Disease • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology • Seronegative Spondyloarthropathies • Spondylarthritis • Urticaria

Mucositis Pain and Its Temporal Relationship to White Cell Count. (PubMed, Paediatr Anaesth) - "Pain relief from mucositis is related to an increase in white cell count after a period of severe neutropenia, where white cell count is a surrogate for neutrophil count. There is a delay in analgesic response of approximately 1 day. This analgesic response to increasing white cell count had greater dominance than analgesia achieved using either opioids or ketamine."

Journal • Observational data • Hematological Disorders • Mucositis • Neutropenia • Oncology • Pain • Pediatrics

Developing an Ecotoxicological Classification for Frequently Used Drugs in Primary Care. (PubMed, Int J Environ Res Public Health) - "Fifteen APIs were designated as safe (category (1):paracetamol, tramadol, amisulpride, citalopram, mirtazapine, metformin, gabapentin, lamotrigine, primidone, candesartan, irbesartan, atenolol, hydrochlorothiazide, ofloxacin, sulfadiazine), eleven as intermediately safe, and nine were of concern (azithromycin, ciprofloxacin, clarithromycin, sulfamethoxazole, carbamazepine, diclofenac, ibuprofen, iomeprol, iopromide). Where data do exist, we observed significant differences in environmental impact among the same class of drugs. Our classification could therefore help guide doctors to adopt more eco-friendly prescriptions."

Journal

Opioid Utilisation in Hungary: National and Regional Analysis in Ambulatory and Hospital Care Sector. (PubMed, J Clin Med) - "Tramadol combinations grew notably in ambulatory care, with tramadol-paracetamol rising from 0.37 DID to 2.17 DID (484.61% increase) and tramadol-dexketoprofen from 0.12 DID to 0.91 DID (650.27% increase)... Opioid use is increasing in Hungarian ambulatory care while remaining steady in the hospital sector. Regional variations are possibly linked to demographic and economic factors in ambulatory care."

Journal

Abuse and misuse of tramadol in patients with non-oncologic pain in a region of Southern Europe. (PubMed, J Pharm Policy Pract) - "The combination of tramadol and paracetamol was reported in 54.6% of the cases and 73.7% corresponded to immediate-release tablets. The involvement of characteristics such as gender as well as the pharmaceutical form in the development of tramadol misuse also needs to be analysed deeply. It is mandatory to evaluate the criteria for prescribing tramadol and initiatives to improve the knowledge of the health professionals and the population."

Journal • Pain

Opioid Prescribing Trends by Croatian Dentists - Is there a Reason for Concern? (PubMed, Acta Stomatol Croat) - "Tramadol/paracetamol and tramadol were the most prescribed opioids, with average annual number of prescriptions amounting to 622, 7 (64% of opioids prescriptions) and 114, 5 (1, 1% of analgesic prescriptions), respectively...But an overall increasing trend was observed during that period. Dentists in Croatia are restrictive and conservative in prescribing opioids, and there is no need for intervention, but because of increasing trends, observing the prescribing pattern in the future is highly recommended."

Journal • Pain

Do Psychological Factors Affect Life Satisfaction and Pain Interference in Spine Surgery Patients? A 12-Month Follow-Up Study. (PubMed, J Clin Med) - " This study was a secondary analysis of a study involving 120 patients who underwent elective spine surgery and were randomly assigned to receive either tramadol-paracetamol (37.5 mg/325 mg; two tablets; n = 61) or placebo (n = 59) twice per day for pain management during the first five postoperative days. The linear regression analysis revealed no statistically significant predictive value for preoperative anxiety, depression, or resilience score for life satisfaction and pain interference at 12 months after spine surgery. These results highlight that psychological factors, anxiety, depression, and resilience did not have an impact on postoperative pain outcomes and life satisfaction in patients undergoing spine surgery."

Journal • Surgery • CNS Disorders • Depression • Orthopedics • Pain • Psychiatry

Pregabalin for Neuropathic Pain in Post-radiotherapy Head and Neck Cancer Patients: A Retrospective Study and Review of the Literature. (PubMed, Cureus) - "Pregabalin may be a promising option for managing RT-related chronic NP in HNC patients. Further studies, including randomized controlled trials on RT-treated HNC patients, should be conducted."

Journal • Retrospective data • Review • Head and Neck Cancer • Nasopharyngeal Carcinoma • Neuralgia • Oncology • Pain • Solid Tumor

Genetic Association of Chronic Pains and Analgesics With Telomere Length: A Mendelian Randomization Study. (PubMed, Biol Res Nurs) - "Objective: The aim of this study was to explore the causal relationships between chronic pains (back pain, facial pain, general pain, headaches, knee pain, hip pain, neck/shoulder pain, stomach/abdominal pain) and analgesics (codeine, diclofenac, ibuprofen, morphine, paracetamol, tramadol) with telomere length using Mendelian randomization methods. However, no significant causal relationships were found with other types of chronic pains and analgesics. This could help develop healthier chronic pain treatments, avoiding the abuse of analgesics."

Journal • Back Pain • Musculoskeletal Pain • Pain

Atypical Presentation of Rapidly Progressive Cutaneous Metastases of Clear Cell Renal Carcinoma: A Case Report. (PubMed, Medicina (Kaunas)) - "Despite the patient's stable oncological treatment for six months, pain management had recently included paracetamol, tramadol, and NSAIDs...This case highlights the potential for extremely rapidly evolving cutaneous metastases from ccRC and their capacity to occasionally mimic atypical drug eruptions. Additionally, it reaffirms the poor prognosis of such metastases, as evidenced by the patient's death within two months."

Review • Dermatology • Kidney Cancer • Oncology • Pain • Palliative care • Sarcoma • Solid Tumor • CA9 • MME • PAX8

Effective Pain Management of Postherpetic Neuralgia Using a Combination of Analgesics and Conservative Measures. (PubMed, Cureus) - "Treatment was initiated with a range of medications, including mecobalamin, pregabalin, and a combination of tramadol and acetaminophen, along with general pain relievers standardized as WHO Step 1 medications, which include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs)...Due to the patient's depression and the concurrent use of a selective serotonin reuptake inhibitor, duloxetine hydrochloride could not be prescribed. Instead, opioid therapy with continuous fentanyl citrate infusion was initiated...The use of conservative measures such as hot compresses also contributes to symptom relief. Alleviating pain symptoms using a combination of pharmacotherapeutic and non-pharmacological treatments is extremely important."

Journal • Angiosarcoma • CNS Disorders • Depression • Herpes Zoster • Neuralgia • Oncology • Pain • Psychiatry • Sarcoma • Solid Tumor • Varicella Zoster

An Unusual Case of High-Renin Hypertension (KIDNEY WEEK 2024) - "Introduction: We present an unusual case in which negative sodium balance was the etiology of high renin hypertensionCase Description: A 75-year-old woman consulted us due to high blood pressure.PMH: LBP, history of excessive NSAIDS use, s/p partial colectomyMeds : amlodipine, zolpidem, bisacodyl, pregabalin, , acetaminophen tramadol, brotizolam, atorvastatin, ezetimibe, esomeprazoleBP- 150/84mmHgLabs - 24 hour urine collection – 240 mg protein (0 albumin), intermittent leukocytuiaRenal US – echogenic diminished parenchymaOn addition of low dose ARB ( 25mg losartan) her creatinine rose from 1.28 to 1.87 mg/dL, blood pressure dropped to 101/64 mmHg, and renin was found to be elevated to >500 microunits/ml. Aldosterone was also extremely elevated to 64.7ng/dlRenal artery doppler showed no evidence of renal artery stenosis.She reported keeping to a low salt diet as well self-prescribing 10 tabs of bisacodyl every evening (!) We suspected sodium malabsorption, and,..."

Clinical • Cardiovascular • Endocrine Disorders • Hypertension • Hypotension

EOIB for Laparoscopic Cholecystectomy (clinicaltrials.gov) - P=N/A | N=60 | Recruiting | Sponsor: Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital | Not yet recruiting ➔ Recruiting

Enrollment open • Gastroenterology • Hepatology • Pain

Occurrence of micropollutants in surface waters: Monitoring of Portuguese Lima and Douro River estuaries and interconnecting northwest coast. (PubMed, Mar Pollut Bull) - "In general, the MPs found more frequently were isoproturon and perfluorooctanesulfonic acid, along with pharmaceuticals trimethoprim, acetaminophen, tramadol, diclofenac, and ketoprofen, which were mostly detected at higher concentrations. Although most MPs have been detected at very low levels, their persistent and widespread presence highlights the need for mitigation measures and effective water treatment solutions able to address them."

Journal

EOIB for Laparoscopic Cholecystectomy (clinicaltrials.gov) - P=N/A | N=60 | Not yet recruiting | Sponsor: Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital

New trial • Surgery • Gastroenterology • Hepatology • Pain