Efficacy and tolerability of tapentadol prolonged release during rehabilitation: a prospective, observational study

M. Orfei, P. Milia, M. Caserio, T.C. Bagaphou

Istituto Prosperius Tiberino, Intensive Rehabilitation Centre, Umbertide, Perugia, Italy. matteo.orfei@gmail.com

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• Anesthesiology

OBJECTIVE: The treatment of chronic pain frequently combines pharmacologic and non-pharmacological options, and analgesia after surgery is of major importance. Tapentadol is both µ-opioid receptor agonist (with a 40% agonism on these receptors) and noradrenaline reuptake inhibitor, with similar analgesic efficacy to strong opioids, but fewer adverse effects. For these reasons, tapentadol may represent a valuable first choice option in the treatment of chronic, neuropathic, and mixed pain.
PATIENTS AND METHODS: The primary endpoint of the present study was the proportion of responder patients, with ≥30% reduction in pain intensity during loading on the NRS; several additional endpoints were also evaluated.
RESULTS: Twenty-five adult patients were enrolled, with a rate of response to treatment of 100%. Moreover, pain reduction was as high as 50% in 23/25 patients (92%). The average NRS at rest at V0 was 7.2 ± 1.0, whereas the average NRS at loading was 7.7 ± 0.9; this score significantly decreased at all visits. The score of the Roland-Morris questionnaire, a score of disability, improved significantly throughout the study (p<0.0001), as well as the Barthel Index (p<0.0005), and the neuropathic component of pain, which was significantly reduced during the study, from 88% at V0 to 12% at V3. Sleep quality improved throughout the study, and the treatment was rated as good (91% of patients) or optimal (9%).
CONCLUSIONS: Our findings show that tapentadol PR may contribute to improve patients’ quality of life, especially during rehabilitation after back surgery, when tapentadol PR treatment is effective and well tolerated.

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