tramadol is developed for 1 unique indication across 1 therapeutic area.
Therapeutic Area
Condition
Phase
Gastrointestinal disorders
Abdominal pain
✓ Approved
Related Research Articles
PubMedAgri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology2026-05-22
AI-assisted versus conventional ultrasound-guided PECS II block: A randomized study in mastectomy patients.
Yazar Çağla Ç, Kesimci Elvin E
This study aims to compare the analgesic efficacy and procedural efficiency of pectoral (PECS II) blocks performed using artificial intelligence (AI)-integrated ultrasonography (USG) versus conventional USG in patients undergoing modified radical mastectomy (MRM).
Between November 2021 and March 2023, a total of 70 female patients scheduled for unilateral MRM under general anesthesia were included in this randomized study. The patients were randomly allocated into two groups: USG group (n = 35) and AI-USG group (n = 35). A fourth-year anesthesiology resident performed the PECS II blocks under the supervision of a senior anesthesiologist. The primary outcome was the postoperative pain score as assessed by Visual Analog Scale (VAS) at 12 hours. Secondary outcomes included pain scores at other postoperative time points, total opioid consumption, time first to rescue analgesia request within 24 hours, and the resident's skill development at the end of the study.
The mean age was 55.3±11.4 (range, 35 to 75) years. Intraoperative remifentanil consumption was higher in USG group than in AI-USG group; however, the difference was not statistically significant (p > 0.05). The durations of anesthesia and surgery were shorter in AI-USG group (p = 0.005 and p = 0.008, respectively). A comparison of local anesthetic injection times between the first 35 and the last 35 patients revealed a statistically significant decrease in the USG group (4.0 min vs. 3.0 min, p = 0.014). The VAS pain scores in the post-anesthesia care unit were initially higher in the AI-USG group (p = 0.05); however, at 12 and 24 postoperative hours, VAS scores were significantly lower than those in the USG group (p = 0.005 and p < 0.001, respectively). There was no significant difference in total tramadol consumption via PCA during the first 24 hours postoperatively (p > 0.05). Surgeon satisfaction scores were lower in the AI-USG group (p = 0.037).
Our study results suggest that AI-enhanced USG guidance is associated with improved analgesic outcomes and may offer clinical and educational advantages in the performance of PECS II blocks, particularly for residents in training. The integration of AI into routine USG-guided regional anesthesia practice holds promise for improving procedural consistency and supporting novice practitioners.
Lentiviral-mediated expression of cytochrome P450 2D6 in HepaRG cells: new means for in vitro xenobiotic biotransformation and cellular response to chimeric viral mRNA.
Coppens-Exandier Hugo H, Mackanga Franz F, Darde Thomas T, Bonhomme Corentin C et al.
The human HepaRG™ cell line is the closest surrogate to primary culture of hepatocytes (PHH) for toxicology studies. However, differentiated HepaRG™ cells express low levels of the cytochrome P450 2D6 (CYP2D6) involved in the biotransformation of many drugs. Herein, progenitor HepaRG™ cells were transduced using lentiviral particles encoding both human CYP2D6 and GFP proteins. The resulting transgenic HepaRG™ cells stably expressed catalytically active CYP2D6 at levels close to those observed in PHH from rapid metabolizers and HepaSH™ hepatocytes. In CYP2D6 transgenic HepaRG™ cells, tramadol was metabolized into both N- and O-desmethyl tramadol as seen in humans while parental HepaRG™ cells produced only N-desmethyl tramadol. Following treatment with perhexiline, the CYP2D6 expressing HepaRG™ cells exhibited higher IC50 values and reduced mitochondrial damages compared to those found in parental cells. Transcriptomic analysis revealed that the expression of CYP2D6 did not significantly affect the cells' ability to proliferate and differentiate or compromise key hepatocyte-specific functions. However, we identified a small number of genes, including NXF3 and TRIM63, which were up-regulated in transgenic cells. Using CRISPR/Cas9-mediated knockdown of GFP and/or CYP2D6 sequences, we demonstrated that NXF3 mRNA and protein inductions were triggered by the lentiviral mRNA encoding GFP and CYP2D6 rather than by genomic transgene integration. Together, these findings establish CYP2D6-transgenic HepaRG™ cells as an optimized and reliable hepatocyte-like model for studying the metabolism and toxicity of CYP2D6 substrates. Our results also support the hypothesis that the NXF3 gene may be a marker of cellular response to the expression of a lentiviral chimeric mRNA.
Chemical Profiling, Pharmacological Activities, and Toxicity Assessment of Juniperus phoenicea sp. turbinata L. Extract: Integrated In Vitro, In Vivo, and In Silico Insights.
Chelouati Tarik T, Lafraxo Soufyane S, Metouekel Amira A, Messkini Mostafa M et al.
Juniperus phoenicea ssp. Turbinata L. (J. phoenicea ssp. Turbinata) has long been used in traditional medicine to treat a variety of ailments. This study aimed to investigate the pharmacological potential and to characterize the phytochemical composition of the hydroethanolic leaf (JPEF) and fruit (JPEG) extracts. Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) analysis revealed that both JPEF and JPEG contained high levels of phenolic compounds, with ferulic acid identified as the dominant constituent. The biological evaluation began with acute toxicity tests in rodents, which indicated that JPEF and JPEG extracts were well tolerated at the doses administered, with no significant adverse effects observed. The extracts exhibited strong anti-inflammatory activity (94.23% for JPEF; 83.24% for JPEG), comparable to that of diclofenac (97.02%), as well as a notable analgesic effect (75% and 70.62%), compared to tramadol (87.01%). Significant antioxidant activity was observed (DPPH IC50: 70.2 and 90.76 μg/mL), accompanied by antimicrobial activity (bacterial inhibition zones: 11.44-20.36 mm; fungal: 13.59-20.38 mm). Molecular docking revealed a stable interaction between the compounds and several enzymatic targets. These results confirm the potential of J. phoenicea ssp. turbinata as a promising source of therapeutic agents.
PubMedRegional anesthesia and pain medicine2026-05-20
Association between preoperative vitamin D level and postoperative pain in patients undergoing breast cancer surgery: a prospective observational study.
Abdelhady Mahdy Ahmed MA, Boulos Maged Labib ML, Hamed Mohamed Ahmed MA, Masry Doha Hamad DH et al.
This study investigated the relationship between preoperative serum vitamin D levels and acute postoperative pain scores in patients undergoing unilateral breast cancer surgery.
The study was conducted at Fayoum University Hospital between September 2024 and April 2025. 184 American Society of Anesthesiologists (ASA) II-III female patients scheduled to undergo elective unilateral modified radical mastectomy were classified into two groups: 92 vitamin D-deficient (<30 nmol/L) and 92 vitamin D-sufficient (≥30 nmol/L). The primary outcome was the occurrence of moderate to severe postoperative pain (Numerical Rating Scale (NRS) >3) at 12 hours. A secondary 24-hour composite outcome (NRS >3 at any time within the first 24 hours) was used for the multivariable logistic regression. Other secondary outcomes included: preoperative serum 25(OH)D level, postoperative NRS, intraoperative fentanyl consumption, postoperative tramadol consumption, sedation scores, intraoperative and postoperative hemodynamics, patient satisfaction, and hospital stay.
The baseline characteristics were well balanced between the groups, with small standardized mean differences for all variables. Patients with vitamin D deficiency had a higher occurrence of moderate to severe pain at 12 hours. In multivariable analysis, vitamin D deficiency was independently associated with moderate to severe postoperative pain at any time point during the first 24 hours (adjusted OR 3.12, 95% CI 1.58 to 6.13). Vitamin D-deficient patients had higher intraoperative fentanyl consumption (mean difference 8.04 µg, 95% CI 3.21 to 12.88) and postoperative tramadol consumption (mean difference 112.17 mg, 95% CI 101.44 to 122.91).
Vitamin D deficiency is associated with a higher occurrence of moderate to severe postoperative pain and increased opioid consumption in patients undergoing unilateral modified radical mastectomy.
PubMedIranian journal of pharmaceutical research : IJPR2026-05-19
Impact of Mild Traumatic Brain Injury (mTBI) on CYP2D6 Activity and the Restorative Effects of Melatonin and Vitamin C Supplementation.
Berenjian Kaveh K, Gholipour Ziba Z, Khoshayand Mohammadreza M, Sharifzadeh Mohammad M et al.
Mild traumatic brain injury (mTBI) may disrupt hepatic cytochrome P-450 enzyme activity, potentially altering drug pharmacokinetics.
This study investigated the impact of mTBI on CYP2D6 activity and the restorative effects of melatonin and vitamin C supplementation.
Mild traumatic brain injury was induced in rats using a modified weight-drop model, which were then assigned to treatment or control groups. CYP2D6 activity was assessed at multiple time points post-injury using metabolic ratios of tramadol and mirtazapine through isolated liver perfusion. All experimental procedures were conducted with the investigator blinded to group assignments.
Mild traumatic brain injury significantly suppressed CYP2D6 activity on day 3, with partial recovery by day 7. While tramadol metabolism normalized by day 28, mirtazapine metabolism remained impaired in non-supplemented groups. Supplementation accelerated CYP2D6 recovery, showing statistically significant change by day 7. By day 28, supplemented groups exhibited metabolic ratios surpassing baseline levels.
Mild traumatic brain injury induces transient suppression of CYP2D6 activity, which was attenuated in antioxidant-treated groups in this preclinical model. Further studies are needed to explore the clinical relevance of these findings.
Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block Compared with Conventional Analgesia for Postoperative Analgesia in Breast Cancer Surgery: A Randomized Controlled Trial.
Baytar Merve Sena MS, Baytar Çağdaş Ç, Kuyumcu Büşra Sena BS, Köksal İncegül Bengü G BG et al.
The aim of this study was to compare the analgesic efficacy and recovery outcomes of the serratus posterior superior intercostal plane block (SPSIPB) and the serratus anterior plane block (SAPB) with conventional analgesia in patients undergoing oncoplastic breast surgery.
One hundred and five patients aged 18-65 years with an ASA physical status of I-III were included in this prospective, randomized controlled study. Patients were randomly assigned in a 1:1:1 ratio to three groups: the Control Group, the SPSIPB Group, and the SAPB Group. Outcome assessors were blinded to group allocation. The primary outcome was cumulative tramadol consumption during the first 24 h postoperative. Secondary outcomes included Numeric Rating Scale (NRS) scores at rest and during activity, Quality of Recovery-15 (QoR-15) scores, and the incidence of postoperative nausea and vomiting (PONV).
Cumulative tramadol consumption during the first 24 h was significantly lower in the SPSIPB and SAPB groups compared with the Control Group (p < 0.001), with no significant difference between the two block groups. Although NRS pain scores were comparable among groups at all time points, QoR-15 scores were significantly higher and antiemetic requirements were lower in both block groups compared with the Control Group.
The SPSIPB and SAPB reduced opioid consumption and improved quality of recovery compared with conventional management, despite similar pain scores, with no significant difference between the two techniques.