Hydrocodone vs. Tramadol for Acute Musculoskeletal Pain.

Tramadol is a centrally acting analgesic that binds to mu-opioid receptors, but chemically is not an opioid. It has become a popular choice for both acute and chronic pain. In this randomized double-blind trial, 68 adults with acute musculoskeletal pain in the emergency department received an oral dose of either tramadol (100 mg) or hydrocodone/acetaminophen (5 mg/500 mg). All patients had fractures, sprains, strains, or contusions resulting from minor trauma, and were judged not to require parenteral analgesia.

On a 100-point visual analog pain scale, both groups rated initial pain at 69. The pain score in the tramadol group decreased to 54 at one hour, then plateaued. In contrast, the pain score in the hydrocodone/acetaminophen group decre…