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Master Thesis

Sécurité du tramadol buvable à faible dose chez la personne âgée de 75 ans et plus : étude rétrospective des effets indésirables sur un an en service de gériatrie au CHU de Caen

Abstract : Background: In France, tramadol is among the commonest prescribed painkillers. Doctors fear the frequent adverse effects reported and even more reluctant to prescribe in elderly over 75, a vulnerable population on which data on safety are scarce. Compared to the commonest formulations, the formulation in oral drops allows the administration of smaller doses and a better control of the titration. The objective was to assess the safety of tramadol in oral drops formulation prescribed to patients over 75. Secondary objectives were to assess patients insufficient pain relief and to look at risk factors in patients who stopped the titration. Methods: A retrospective, monocentric study was conducted in the geriatrics department of the CHU in Caen, France. In 2017, patients who received tramadol at a daily dose not exceeding 40 drops were included. Data were collected within the first 15 days after admission. Results: 149 patients were included; the average age was 88.5 (± 5,51) year-old. Twelve (8.1%) patients experienced a serious adverse reaction requiring cessation of treatment. Among those, 10 presented agitation or confusion. There was no evidence for risk factors in these patients. Seventeen (11.4%) declared insufficiently alleviated. The proportion of chronic and acute component pain in this group was higher than in the rest of the study population (18,8% vs 52,9%; p=0,001). Conclusion: From this exploratory analysis, the security of tramadol seems acceptable. With a rigorous medical follow-up, this formulation could improve pain management, but more research is needed to offer good clinical practice recommendations for the management of pain in patients over 75.
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Submitted on : Thursday, January 30, 2020 - 12:23:11 PM
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Camille Gaugain. Sécurité du tramadol buvable à faible dose chez la personne âgée de 75 ans et plus : étude rétrospective des effets indésirables sur un an en service de gériatrie au CHU de Caen. Médecine humaine et pathologie. 2019. ⟨dumas-02460847⟩

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