PREMEDICATION WITH TRAMADOL IN PATIENTS UNDERGOING COLONOSCOPY: A DOUBLE-BLIND RANDOMIZED PLACEBO-CONTROLLED STUDY.

Colonoscopy is often disturbed by poor patient tolerance; benzodiazepines or opiates are routinely
used to overcome such problems, despite the possibility of undesired effects. Tramadol, an opiate
analogue with potentially fewer side effects, has not been tested yet to this end. The aim of the
study was therefore to evaluate the efficacy of tramadol as a premedication for the colonoscopic
procedure. Fifty patients were randomly allocated to receive an i.v. infusion of 100 ml saline, with
100 mg tramadol or alone, before endoscopy. At the end of the procedure patients were asked to
score the discomfort experienced and to give an exam evaluation. The endoscopist also analyzed his
performance. Tramadol patients reported a pain score of 39 ± 13 (mean±SE), compared to 45 ± 10
for the placebo group (P = 0.25); the evaluation of endoscopy was also similar (tramadol, 66 ± 12;
placebo, 70 ± 9; P = 0.15). The endoscopist also reported a similar score (65 ± 4 after tramadol;
69 ± 4 after placebo; P = 0.2). No significant sex- or age-related differences were detected. We
conclude that tramadol, at least as a monotherapy, seems scarcely effective for controlling pain
evoked by colonoscopy.