Paper I
Question
Tramadol as analgesic
Answer
Tramadol has a dual mechanism of action — weak μ-opioid receptor agonism combined with inhibition of serotonin and noradrenaline reuptake in the descending pain-inhibitory pathways. This dual mechanism provides analgesia comparable to moderate-strength opioids for moderate to moderately severe pain, while carrying a lower abuse/dependence potential and less respiratory depression than full opioid agonists like morphine, making it a useful option when a stronger analgesic than NSAIDs is needed but full opioids are not yet warranted.