El control del dolor en la artrosis del pulgar suele basarse en la terapia antiinflamatoria. Una situación clínica particular surge cuando los AINEs no pueden utilizarse — por contraindicaciones, intolerancia o respuesta insuficiente — y no quedan otras alternativas analgésicas viables.
En este contexto, las guías contemplan condicionalmente una opción analgésica de clase opioide para el alivio del dolor — los detalles completos del protocolo, incluidas las condiciones de uso, están disponibles a continuación.
DOI: 10.1016/j.rdc.2022.03.009.
Recommendations on the use of tramadol were mixed, either conditionally/weakly against or conditionally/weakly for; this variation was primarily related to the recognition that some patients require an option for pain management when oral NSAIDs are not an option (contraindicated, not tolerated, or ineffective), particularly when considering input from patient panels.
Opioids, including tramadol, are generally not recommended, though guidelines did acknowledge that in some cases, such as in instances of contraindications, intolerance to, or inadequate response to NSAIDs, tramadol can be considered for pain relief in the absence of other viable options.
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