Title: Recommendations

Context:
Tramadol: There is low quality evidence that tramadol may be more effective than placebo for pain relief. In one  short-term study, compared to placebo, tramadol was more effective for pain.[146] There is no long-term  evidence of the comparative efficacy of tramadol versus another opioid or a non-opioid comparison such  as non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. Due to tramadol’s partial mu  agonist activity and demonstrated safety profile when used in conjunction with acetaminophen in elderly  patients, it may be a preferred agent in that patient group.[147,148]

Question: Is there any evidence of the comparative efficacy of tramadol versus another opioid or a non-opioid comparison such  as non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen?

Answer: no long-term  evidence