Analgesics in ophthalmic practice: A review of the oral non-narcotic agenttramadol

This report reviews the causes of ocular pain and discusses the pharmacolog y, pharmacokinetics, efficacy, adverse effects, and dosage of tramadol, a n ovel non-narcotic oral analgesic. Tramadol is a synthetic analog of codeine with a dual mechanism of action that involves agonist activity at the mu o pioid receptor, as well as inhibition of monoaminergic (norepinephrine and serotonin) re-uptake. Unlike opiate analgesics, tramadol has very low prope nsity toward physical dependence. Common dose-related adverse effects of tr amadol include dizziness, nausea, vomiting, dry mouth, and/or drowsiness. C linically, tramadol has been shown to be equivalent to acetaminophen (325 m g)codeine (30 mg) combinations for the treatment of moderate or severe nono cular pain. Tramadol appears to be an effective analgesic agent for pain co ntrol due to postoperative surgical trauma, as well as in various chronic m alignant and nonmalignant disease states. Tramadol has shown variable effec tiveness in the control of pain related to dental procedures. The usefulnes s of tramadol in pain states from ophthalmic origin has yet to be clinicall y established.