Tapentadol vs Tramadol in Arthroscopic Rotator Cuff Repair

NCT07779473 — Active not recruiting, 64 participants, University of Thessaly

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Comparison of Tramadol vs Tapentadol as Postoperative Analgesia in Arthroscopic Rotator Cuff Repair Surgery

RegistryNCT07779473
StatusActive not recruiting
Study typeObservational
Enrollment64 (Estimated)
SponsorUniversity of Thessaly (Other)
ConditionsArthroscopic Rotator Cuff Repair (ARCR), Postoperative Pain, Chronic Pain
InterventionsTramadol, Tapentadol (Drug)
Datesstart 2026-07-01, primary completion 2029-07-01 (estimated), completion 2029-09-01 (estimated), first posted 2026-08-21, last updated 2026-10-21
Locations1 site in Greece

Related Papers Related Patents Related Grants Related Experts
All trials for Arthroscopic Rotator Cuff Repair (ARCR) All trials for Postoperative Pain All trials of Tramadol All trials of Tapentadol

-Summary

Compare the effectiveness of tapentadol and tramadol as part of a multimodal analgesia treatment for Arthroscopic Rotator Cuff Repair Surgery.

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+Detailed description

Arthroscopic rotator cuff repair (ARCR) is considered the treatment of choice for rotator cuff tears. Despite its minimally invasive nature, the procedure is associated with significant acute postoperative pain and, in a proportion of patients, with the development of chronic postoperative pain and stiffness, which may adversely affect rehabilitation, functional outcomes, and quality of life.

Contemporary postoperative pain management is based on multimodal analgesic protocols aimed at achieving adequate pain control while reducing opioid use and opioid-related adverse effects. Tramadol and tapentadol are centrally acting opioids with atypical mechanisms of action that are commonly used in clinical practice as part of multimodal analgesia. However, available data regarding their comparative effectiveness and safety in patients undergoing ARCR remain limited.

The aim of the present study is to compare the effectiveness of tapentadol versus tramadol in the management of postoperative pain in patients undergoing arthroscopic rotator cuff repair at the University General Hospital of Larissa.

The study will include patients aged 18-80 years, classified as ASA Physical Status I-III, who meet the predefined inclusion and exclusion criteria. Participants will be randomized into two groups and will receive, within a standardized multimodal analgesic protocol, either tapentadol or tramadol. All patients will undergo identical anesthetic and surgical management in accordance with established departmental clinical practice.

The primary outcome measure is pain intensity at rest and during movement, assessed using validated pain scales (VAS/NRS) at 6, 12, and 24 postoperative hours, as well as on postoperative days 1, 2, and 3. Secondary outcome measures include the occurrence of adverse effects, sleep quality, patient and surgeon satisfaction, and measures of functional outcome, quality of recovery, and quality of life assessed at 3 and up to 6 months postoperatively. The presence of neuropathic pain will also be assessed preoperatively and at 3 and 6 months postoperatively using the PainDETECT questionnaire, while depressive symptoms will be evaluated preoperatively and at 6 weeks, 3 months, and 6 months postoperatively using the Patient Health Questionnaire-9 (PHQ-9).

Participation will be entirely voluntary following the provision of written informed consent. Participant anonymity and personal data protection will be ensured in accordance with applicable national and European legislation (GDPR). This study is expected to contribute to the optimization of postoperative analgesic protocols following ARCR and to the improvement of the quality of patient care.

+Arms and interventions

ArmTypeInterventionsDescription
TramadolDrug: TramadolTramadol will be administered in a multimodal analgesic approach to manage postoperative pain.
TapentadolDrug: TapentadolTapentadol will be administered in a multimodal analgesic approach to manage postoperative pain.
  • Tramadol (Drug): Add tapentadol, for effective pain management in a multimodal setting during ARCR
  • Tapentadol (Drug): Add tramadol, for effective pain management in a multimodal setting during ARCR

+Outcome measures

Primary outcomes

  • Post-operative pain [6 hours after surgery]: Numerical Rating Scale (NRS) score measures 0 to 10 (0=no pain, 10=the worst pain)
  • Post-operative pain [12 hours after surgery]: Numerical Rating Scale (NRS) score measures 0 to 10 (0=no pain, 10=the worst pain)
  • Post-operative pain [1st postoperative day]: Numerical Rating Scale (NRS) score measures 0 to 10 (0=no pain, 10=the worst pain)
  • Post-operative pain [2nd postoperative day]: Numerical Rating Scale (NRS) score measures 0 to 10 (0=no pain, 10=the worst pain)
  • Post-operative pain [3rd postoperative day]: Numerical Rating Scale (NRS) score measures 0 to 10 (0=no pain, 10=the worst pain)

Secondary outcomes

  • Post-operative pain [3 weeks after surgery]: Numerical Rating Scale (NRS) score measures 0 to 10 (0=no pain, 10=the worst pain)
  • Post-operative pain [6 weeks after surgery]: Numerical Rating Scale (NRS) score measures 0 to 10 (0=no pain, 10=the worst pain)
  • Post-operative pain [3 months after surgery]: Numerical Rating Scale (NRS) 0 to 10 (0=no pain, 10=the worst pain)
  • Post-operative pain [6 months after surgery]: Numerical Rating Scale (NRS) score measures 0 to 10 (0=no pain, 10=the worst pain)
  • Neuropathic pain [6 months after surgery]: PainDETECT(not an abbreviation) (0-35 scale with 0-12 being negative result for neuropathic pain 13-18 ambiguous result and 19-35 positive for neuropathic pain)
  • Quality of recovery [preoperatively]: Quality of Recovery-15 ( QoR15) ( scale 0-10 with 0 being poor outcome and 10 being excellent outcome)
  • Patient Satisfaction [1st postoperative day]: 5-point Likert scale (not an abbreviation) (0-5) \[5 representing higher satisfaction\]
  • Function [6 weeks after surgery]: ROWE Score(not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [3 months after surgery]: ROWE Score (not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [6 months after surgery]: ROWE Score (not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [6 weeks after surgery]: The Constant-Murley Score (not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [3 months after surgery]: The Constant-Murley Score (not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [6 months after surgery]: The Constant-Murley Score (not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [6 weeks after surgery]: DASH score (Disabilities of the Arm, Shoulder and Hand)(scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [3 months after surgery]: DASH score (Disabilities of the Arm, Shoulder and Hand) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [6 months after surgery]: DASH score (Disabilities of the Arm, Shoulder and Hand) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [6 weeks after surgery]: ASES (American Shoulder and Elbow Surgeons) Shoulder Score (scale 0-100 with 0 being poor outcome 100 being excellent outcome and is split evenly into two 0-50 subscores for pain and function)
  • Function [3 months after surgery]: ASES (American Shoulder and Elbow Surgeons) Shoulder Score (scale 0-100 with 0 being poor outcome 100 being excellent outcome and is split evenly into two 0-50 subscores for pain and function)
  • Function [6 months after surgery]: ASES (American Shoulder and Elbow Surgeons) Shoulder Score (scale 0-100 with 0 being poor outcome 100 being excellent outcome and is split evenly into two 0-50 subscores for pain and function)
  • Quality of sleep [1st postoperative day]: Athens Insomnia Scale (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Quality of sleep [2nd postoperative day]: Athens Insomnia Scale (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Quality of sleep [3rd postoperative day]: Athens Insomnia Scale (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Quality of sleep [3 weeks after surgery]: Athens Insomnia Scale (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Quality of sleep [6 weeks after surgery]: Athens Insomnia Scale (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Quality of sleep [3 months after surgery]: Athens Insomnia Scale (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Quality of sleep [6 months after surgery]: Athens Insomnia Scale (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Quality of recovery [24 hours after surgery]: Quality of Recovery-15 ( QoR15) (scale 0-10 with 0 being poor outcome and 10 being excellent outcome)
  • Neuropathic pain [3 months after surgery]: PainDETECT (0-35) (not an abbreviation) (0-35 scale with 0-12 being negative result for neuropathic pain 13-18 ambiguous result and 19-35 positive for neuropathic pain)
  • Depression [preoperatively]: Patient Health Questionnaire 9 (PHQ9) (0-27) \[The higher the score, more severe the depression\]
  • Depression [6 weeks after surgery]: Patient Health Questionnaire 9 (PHQ9) (0-27) \[The higher the score, more severe the depression\]
  • Depression [3 months after surgery]: Patient Health Questionnaire 9 (PHQ9) (0-27) \[The higher the score, more severe the depression\]
  • Depression [6 months after surgery]: Patient Health Questionnaire 9 (PHQ9) (0-27) \[The higher the score, more severe the depression\]
  • Neuropathic pain [preoperatively]: PainDETECT (0-35) (not an abbreviation) (0-35 scale with 0-12 being negative result for neuropathic pain 13-18 ambiguous result and 19-35 positive for neuropathic pain)
  • Health Status [preoperatively]: 5 level EuroQol 5 Dimensions 5 level Score (EQ-5D-5L) (0-100) \[The higher the score, the worse the health status\] (not an abbreviation)
  • Health Status [6 weeks after surgery]: 5 level EuroQol 5 Dimensions 5 level Score (EQ-5D-5L) (0-100) \[The higher the score, the worse the health status\] (not an abbreviation)
  • Health Status [3 months after surgery]: 5 level EuroQol 5 Dimensions 5 level Score (EQ-5D-5L) (0-100) \[The higher the score, the worse the health status\] (not an abbreviation)
  • Health Status [6 months after surgery]: 5 level EuroQol 5 Dimensions 5 level Score (EQ-5D-5L) (0-100) \[The higher the score, the worse the health status\] (not an abbreviation)
  • Quality of sleep [preoperatively]: Athens Insomnia Scale (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Surgeon Satisfaction [1st postoperative day]: 5-point Likert scale (0-5) \[5 representing higher satisfaction\] (scale 0-24 with 0 being excellent outcome and 24 being poor outcome)
  • Joint awareness [6 weeks after surgery]: Forgotten Joint Score (FJS) (scale 0-100 with 0 being poor outcome and 100 being excellent outcome)
  • Joint awareness [3 months after surgery]: Forgotten Joint Score (FJS) (scale 0-100 with 0 being poor outcome and 100 being excellent outcome)
  • Joint awareness [6 months after surgery]: Forgotten Joint Score (FJS) (scale 0-100 with 0 being poor outcome and 100 being excellent outcome)
  • Joint awareness [preoperatively]: Forgotten Joint Score (FJS) (scale 0-100 with 0 being poor outcome and 100 being excellent outcome)
  • Function [preoperatively]: The Constant-Murley Score (not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [preoperatively]: ROWE Score (not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [preoperatively]: DASH score (Disabilities of the Arm, Shoulder and Hand) (not an abbreviation) (scale 0-100 with 0 being poor outcome 100 being excellent outcome)
  • Function [preoperatively]: ASES (American Shoulder and Elbow Surgeons) Shoulder Score (scale 0-100 with 0 being poor outcome 100 being excellent outcome and is split evenly into two 0-50 subscores for pain and function)
  • Nausia and vomiting [1st postoperative day]: Apfel Score (not an abbreviation) (scale 0-4 with 0 being excellent outcome 4 being poor outcome)
  • Nausia and vomiting [2nd postoperative day]: Apfel Score (not an abbreviation) (scale 0-4 with 0 being excellent outcome 4 being poor outcome)
  • Nausia and vomiting [3rd postoperative day]: Apfel Score (not an abbreviation) (scale 0-4 with 0 being excellent outcome 4 being poor outcome)
  • Patient comorbidities [properatively]: Charlson scale (not an abbreviation) (scale that 0 means excellent outcome and more than 5 means poor outcome, there is no absolute scale number)

+Eligibility

Sex: All, ages: 18 Years to 80 Years

Inclusion Criteria:

* Patients for elective ARCR
* ASA PS I - III
* Age 18-80 (adults)

Exclusion Criteria:

* Patient refusal
* Cognitive disfunction
* Severe psychiatric disease
* Under medication with MAO inhibitors, tricyclic antidepressants, serotonin reuptake inhibitors
* Not speaking Greek
* Known allergy to the study drugs
* Contraindications for any of the study drugs
* Chronic renal failure (GFR < 50 ml/h)
* Liver failure
* Known regular use or misuse of opioids
* Pregnant women
* Patients undergoing general anesthesia

+Locations (1)

FacilityCityCountryStatus
Larissa University HospitalLarissa, ThessalyGreece

+Investigators

  • Eleni Arnaoutolglou, MD, PhD, Study chair, Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Principal Investigator
  • Metaxia Bareka, MD, PhD, Principal investigator, Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly