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Due to its good tolerability profile and multimodal mechanism of action, tramadol is generally considered a lower-risk opioid option for the treatment of moderate to severe pain. These pathways are complementary and synergistic, improving tramadol's ability to modulate the perception of and response to pain. Due to its SNRI activity, tramadol also has anxiolytic, antidepressant, and anti-shivering effects which are all frequently found as comorbidities with pain. Similar to other opioid medications, tramadol poses a risk for development of tolerance, dependence and abuse. Tramadol is approved for the management of moderate to severe pain in adults.

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COVID is an emerging, rapidly evolving situation. Pain intensity may be high in the postoperative period after spinal vertebral surgery. The aim of the study was to compare the effectiveness and cost of patient controlled analgesia PCA with tramadol versus low dose tramadol-paracetamol on postoperative pain. A total of 60 patients were randomly divided into two groups. One group received 1. The bolus and infusion programs were adjusted to administer a 1 mL bolus dose of tramadol with a lock time of 10 minutes.

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