tramadol/acetaminophen / Generic mfg. - LARVOL DELTA

Paracetamol Plus Tramadol Versus Fentanyl in Day Case Surgeries (clinicaltrials.gov) - P4 | N=102 | Completed | Sponsor: Zagazig University | Recruiting ➔ Completed | Phase classification: P ➔ P4 | Trial completion date: Sep 2024 ➔ Dec 2025 | Trial primary completion date: Aug 2024 ➔ Dec 2025

Phase classification • Trial completion • Trial completion date • Trial primary completion date • Pain

Ultrasound-guided hominis placenta pharmacopuncture for pain and bone union in traumatic rib fracture: A case report (PAINWeek 2026) - "Full-dose analgesics, including NSAIDs, acetaminophen–tramadol combination, and muscle relaxants, were administered during Feb 9–11... Pain intensity assessed using the NRS demonstrated a clear time-dependent improvement across all conditions (activity, deep breathing, and coughing). During the initial treatment period (Feb 9–11; approximately week 1), pain remained relatively severe, with activity-related NRS 4–5, deep breathing NRS 5–6, and coughing NRS 6–7. Early reduction in pain was observed within the first week of treatment, with more noticeable improvement beginning in the second week."

Case report • Clinical • CNS Disorders • Musculoskeletal Pain • Pain • Sleep Disorder

2026 Taiwan guidelines for the acute pharmacologic treatment of migraine in adults. (PubMed, J Chin Med Assoc) - "Non-specific agents include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs: diclofenac, ibuprofen, naproxen). Injectable prochlorperazine is also strongly recommended. Ergotamine/caffeine combinations are less effective and are second-line agents, while high-dose aspirin is limited by gastrointestinal risk. Considering the potential risk of dependency, tramadol or tramadol/paracetamol combinations should be reserved until all other agents fail, and should be limited to oral forms. Other opioids, such as morphine, butorphanol, etc., lack evidence and are not recommended...Acetaminophen remains first-line for children and pregnant women. To prevent medication-overuse headache, acute treatments, including NSAIDs, acetaminophen, triptans, ergot derivatives, and combination analgesics, should not exceed two days per week, probably with the exception of rimegepant."

Journal • Addiction (Opioid and Alcohol) • Cardiovascular • CNS Disorders • Migraine • Pain

Acute pain and analgesic prescribing in trauma inpatients at a tertiary hospital: A cross-sectional study. (PubMed, J Coll Med S Afr) - "Paracetamol with tramadol remained the dominant regimen, with limited visible change across pain categories. This study provides an inpatient, cross-sectional account of persistent pain after trauma and the analgesics prescribed in a South African tertiary trauma service and may inform local quality-improvement efforts in trauma pain management."

Journal • Observational data • Cardiovascular • CNS Disorders • Diabetes • Human Immunodeficiency Virus • Hypertension • Infectious Disease • Metabolic Disorders • Pain • Psychiatry

NonNarcotic Pain Control in Percutaneous Needle Tenotomy of Elbow (clinicaltrials.gov) - P4 | N=92 | Recruiting | Sponsor: The Cleveland Clinic | Trial completion date: Jun 2026 ➔ Jun 2027 | Trial primary completion date: Jun 2026 ➔ Jun 2027

Trial completion date • Trial primary completion date • Musculoskeletal Pain • Pain

Association of a Physician-Nurse Collaborative Multimodal Analgesic Pathway with Early Pain Trajectories and Institution-Recorded Opioid Use After Total Knee Arthroplasty: A Propensity Score-Matched Retrospective Cohort Study. (PubMed, J Pain Res) - "The modified pathway combined physician-prescribed scheduled celecoxib and tramadol/paracetamol rescue analgesia with nurse-delivered cryotherapy, limb elevation, relaxation training, and perioperative pain education...Primary outcomes were longitudinal resting Visual Analog Scale (VAS) scores and cumulative institution-recorded opioid exposure within 90 days, expressed as oral morphine milligram equivalents (MME)...The bundled physician-nurse collaborative pathway was associated with lower early pain scores, reduced institution-recorded opioid exposure, and less continued opioid prescribing after TKA. Prospective studies with concurrent controls are needed to confirm these findings and determine the contribution of individual pathway components."

Journal • Retrospective data • Musculoskeletal Pain • Orthopedics • Pain

An evaluation of transdermal buprenorphine and transdermal fentanyl patch on quality of recovery-15 and analgesic effect following inguinal hernia surgery: a randomized controlled study. (PubMed, Anesth Pain Med (Seoul)) - "In this prospective, randomized study 150 patients classified as American Society of Anesthesiologists (ASA) I-III scheduled for elective open inguinal hernia repair were randomized into three groups; (n=50 each) Group B (buprenorphine 10 µg/h patch), Group F (fentanyl 25 µg/h patch), and Group C (intravenous paracetamol and tramadol). Transdermal buprenorphine and fentanyl provided effective postoperative analgesia and were associated with improved quality of recovery compared with standard analgesia. Buprenorphine showed a significant advantage over fentanyl in QoR-15 at 24 h, however, this difference was not significant at 48 h."

Journal • Anesthesia • Gastroenterology • Pain

Cost-Effectiveness of Monotherapy versus Polypharmacy in Cervicobrachial Symptoms: A Nationwide Multicenter Analysis. (PubMed, Spine Surg Relat Res) - "Patients received monotherapy (n=112) or multiple-drug therapy (n=149) using five pre-specified agents: loxoprofen, celecoxib, acetaminophen, tramadol-acetaminophen, and pregabalin. Monotherapy, particularly with non-steroidal anti-inflammatory drugs or acetaminophen, offers superior cost-effectiveness and should be prioritized as first-line treatment. These findings underscore the need for restraint in polypharmacy and provide real-world evidence to guide clinical decision-making and national healthcare policy."

Clinical • HEOR • Journal • Monotherapy • Orthopedics

Effectiveness of a Structured Nursing Care Pathway Integrated with Standard Pharmacological Management on Biophysiological and Psychological Outcomes in Patients Undergoing Spinal Anesthesia: A Pilot Quasi-Experimental Study. (PubMed, J Pharm Bioallied Sci) - "Standard pharmacological regimens (e.g., bupivacaine, paracetamol, tramadol, ondansetron, and pantoprazole) address these issues, but integrating structured nursing care pathways may optimize recovery. Integrating structured nursing care pathways with pharmacological management enhances postoperative recovery, reducing complications, and improving patient well-being. Larger randomized trials are recommended to confirm these findings."

Journal • Anesthesia • CNS Disorders • Mood Disorders • Pain • Psychiatry • Sleep Disorder

Nephrostomy Tract Infiltration for Pain Control After PCNL (clinicaltrials.gov) - P=N/A | N=60 | Recruiting | Sponsor: Hitit University

New trial • Anesthesia • Nephrology • Pain • Renal Calculi

Effect of KinesioTaping on Pain at Thoracic Tube Sites After CABG: A Randomized Study. (PubMed, Thorac Cardiovasc Surg) - "Kinesio taping around drain sites post-CABG reduces pain, opioid needs, and ICU stay. This safe approach may enhance early postoperative pain management after cardiac surgery."

Clinical • Journal • Cardiovascular • Infectious Disease • Pain

SMILES-based degree molecular descriptors and machine learning for QSPR modeling of anti-alkaptonuria drugs. (PubMed, Front Chem) - "Nine representative compounds, including Nitisinone, Ascorbic Acid, Ibuprofen, Naproxen, Paracetamol, Tramadol, Methotrexate, Sulfasalazine, and Glucosamine, were analysed using several molecular descriptors such as molecular weight, logP, hydrogen bond donors and acceptors, rotatable bonds, and polar surface area. This study introduces a machine learning-driven QSPR framework that integrates SMILES-derived degree-based topological indices with ensemble learning techniques for predicting physicochemical properties of anti-alkaptonuria drugs. The proposed approach demonstrates improved predictive performance on small datasets and highlights the effectiveness of combining graph-theoretic molecular descriptors with advanced machine learning methods."

Journal • Metabolic Disorders

Short- and Mid-Term Outcomes of Fixed-Dose Tramadol/Paracetamol in Early-Stage Symptomatic Knee Osteoarthritis: A Single-Center Retrospective Observational Extension Study. (PubMed, Life (Basel)) - "These findings should be considered exploratory and hypothesis-generating rather than comparative evidence of effectiveness. Larger controlled studies are needed to confirm durability, comparative benefit, and long-term safety."

Journal • Retrospective data • Immunology • Osteoarthritis • Pain • Rheumatology

Efficacy and safety of oral tapentadol for cancer-related pain: an updated systematic review and meta-analysis. (PubMed, Minerva Med) - "Tapentadol demonstrated similar efficacy and safety compared to other opioids for cancer-related pain, with no evidence of superiority. Given the limited number and methodological quality of studies, further high-quality trials are needed to establish more robust conclusions."

Clinical • Journal • Retrospective data • Review • Oncology • Pain

Evaluation of the Effects of Pecto-Intercostal Fascial Plane Blocks on Extubation Time in Cardiac Surgery: A Retrospective Study. (PubMed, J Clin Med) - "The number of patients requiring postoperative paracetamol and tramadol was statistically significantly lower in Group 1 (p = 0.015 and p < 0.001, respectively). PIFB application in isolated open-heart surgery performed via median sternotomy was associated with shorter extubation time and reduced perioperative fentanyl and postoperative analgesic consumption, without a statistically significant effect on hospital length of stay. Complication and mortality data are reported descriptively; the study does not have sufficient statistical power to draw inferences regarding safety outcomes."

Journal • Retrospective data • Anesthesia • Cardiovascular • Pain

The impact of ubrogepant on the use of other migraine acute treatments, opioid discontinuation, and healthcare utilization: Results from a pre-post opioid subcohort analysis (AHS 2026) - "Acute medications other than ubrogepant included acetaminophen, almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, dihydroergotamine, ergotamine, amobarbital, aprobarbital, butabarbital, butalbital, mephobarbital, metharbital, pentobarbital, phenobarbital, secobarbital, talbutal, barbital, codeine, hydrocodone, meperidine, morphine, oxycodone, propoxyphene, tramadol, aspirin, bromfenac, celecoxib, diclofenac, diflunisal, esomeprazole, etodolac, famotidine, fenoprofen, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, meclofenamate, mefenamic acid, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam, sulindac, tolmetin, lasmiditan, Zavegepant, and Rimegepant (<15 pills). Opioid use included acetaminophen/tramadol, oxymorphone, levorphanol, buprenorphine/naloxone, meperidine, morphine, oxycodone, codeine, methadone, oxycodone, hydromorphone, butorphanol, and tapentadol... In patients with a history of opioid use,..."

HEOR • CNS Disorders • Migraine • Pain

Drug-induced thrombocytopenia in the inpatient rehabilitation unit, a case series. (ISPRM 2026) - "On 4/28/25, Levetiracetam was weaned off, and Enoxaparin was discontinued...Prior to stay, patient was started on Acetazolamide for pulmonary hypertension treatment...PLTs increased from 57,000 (5/16/25) to 92,000 (5/20/25).Third case: 71-year-old male patient with traumatic spinal cord injury due to GLF who received pain management with Ultracet at previous hospital... Drug-induced thrombocytopenia can occur during an inpatient rehabilitation stay. Commonly prescribed medications can be the culprit. Despite literature being scarce, physiatrists should be aware of this condition to diagnose and manage it, while providing safe participation in an intense rehabilitation program following thrombocytopenia guidelines."

Clinical • Cardiovascular • CNS Disorders • Epilepsy • Hematological Disorders • Interstitial Lung Disease • Orthopedics • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Thrombocytopenia

Hookworm infestation in the biliary tract: a case report. (PubMed, J Med Case Rep) - "This instance highlights the fact that hookworms can cause obstructive illness even though they are rare in the biliary system. It emphasizes the importance of timely endoscopic examination and focused antiparasitic therapy, as well as the necessity of taking into account atypical parasitic causes when symptoms cannot be adequately explained by usual biliary disorders."

Journal • Gastroenterology • Hematological Disorders • Hepatology • Infectious Disease • Inflammation • Pain • Pancreatitis

The effect of intravenous flurbiprofen axetil on acute pain in patients undergoing CT-guided lung nodule puncture localization (a randomized controlled study) (ChiCTR) - P=N/A | N=60 | Recruiting | Sponsor: The Affiliated Drum Tower Hospital of Nanjing University Medical School; The Affiliated Drum Tower Hospital of Nanjing University Medical School

New trial • Pain

Clinical Efficacy of Ozone Enema in the Treatment of Postherpetic Neuralgia (ChiCTR) - P=N/A | N=66 | Sponsor: Shanghai Putuo District Central Hospital (Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine); Shanghai Putuo District C

New trial • Neuralgia • Pain

The Role of α-2 Adrenergic Receptor Agonist Dexmedetomidine Alone or in Combination with Ropivacaine in Postoperative Pain Management Following Breast Surgery. (PubMed, Maedica (Bucur)) - "Rescue analgesia with intravenous paracetamol and tramadol was recorded. The combination of dexmedetomidine and ropivacaine significantly improves postoperative analgesia following modified radical mastectomy without increasing adverse effects. Dexmedetomidine appears to be a safe and effective adjuvant within multimodal analgesia strategies."

Journal • Anesthesia • Breast Cancer • Oncology • Pain • Solid Tumor

RECHMPL23_0409: ESP-BACK : Erector Spinae Plane Block for acute low back pain (clinicaltrialsregister.eu) - P4 | N=300 | Not yet recruiting | Sponsor: Centre Hospitalier Universitaire De Montpellier

New P4 trial • Back Pain • Lumbar Back Pain • Musculoskeletal Pain • Pain

TRAMPA: Analgesic Efficacy and Obstetric Effects of Tramadol, Paracetamol and Placebo in Active Labor (clinicaltrials.gov) - P4 | N=300 | Recruiting | Sponsor: Universidad Nacional Autonoma de Honduras

New P4 trial • Obstetrics • Pain

NonNarcotic Pain Control in Percutaneous Needle Tenotomy of Elbow (clinicaltrials.gov) - P4 | N=92 | Recruiting | Sponsor: The Cleveland Clinic | Trial completion date: Dec 2025 ➔ Jun 2026 | Trial primary completion date: Dec 2025 ➔ Jun 2026

Trial completion date • Trial primary completion date • Musculoskeletal Pain • Pain

Intravenous Paracetamol Versus Intramuscular Tramadol in Shortening the Duration of Labour. (clinicaltrials.gov) - P=N/A | N=189 | Completed | Sponsor: Federal Teaching Hospital Abakaliki

New trial