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1: Dig Dis Sci. 1999 Jun;44(6):1107-16.Click here to read Links

Effect of tramadol and morphine on pain and gastrointestinal motor function in patients with chronic pancreatitis.

Wilder-Smith CH, Hill L, Osler W, O'Keefe S.

Gastrointestinal Clinic, Groote Schuur Hospital, University of Cape Town, South Africa.

Tramadol and morphine were compared for treatment of severe chronic pancreatitis pain and their interaction with gut motor function. Oral tramadol or morphine doses were titrated double-blinded and randomized for five days in 25 patients and pain, side effects, bowel function, orocecal and colonic transit, anal resting pressure, and rectal distension thresholds were measured. Pain intensities (mean+/-SD, 0 = none, 100 = unbearable) before treatment and on day 4 were 75+/-19 and 8+/-13 with tramadol (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 as excellent (P < 0.001) with mean respective doses of 840 mg (range: 80-1920) and 238 mg (20-1125). Orocecal transit was unchanged after five days of tramadol, but increased with morphine (P < 0.05). More patients had prolonged colonic transit times with morphine by day 5 (P < 0.05). Rectal distension threshold pressures increased only with tramadol (P < 0.01). It is concluded tramadol and morphine are potent analgesics in severe chronic pancreatitis pain when individually titrated. Tramadol interfered significantly less with gastrointestinal function and was more often rated as an excellent analgesic than morphine.

PMID: 10389680 [PubMed - indexed for MEDLINE]

Patient Drug Information

  • Morphine Oral (Avinza® , Kadian® , MS Contin® , ...)

    Morphine is used to relieve moderate to severe pain. Morphine long-acting tablets and capsules are only used by patients who are expected to need medication to relieve moderate to severe pain around-the-clock for longer ...

  • Tramadol (Ultram® , Ultram® ER, Ultracet® (combination with acetaminophen))

    Tramadol is used to relieve moderate to moderately severe pain. Tramadol extended-release tablets are only used by people who are expected to need medication to relieve pain around-the-clock for a long time. Tramadol is ...

  • Morphine Rectal (RMS® )

    Rectal morphine is used to relieve moderate to severe pain. Morphine is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the body senses pain.

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