diclofenac + tramadol

The Multimodal Oral Scheme utilized by the Hospital Italiano de Buenos Aires is a combination analgesic regimen consisting of the non-steroidal anti-inflammatory drug (NSAID) diclofenac and the synthetic opioid tramadol. This specific scheme was employed as the standard-of-care control arm in a Phase 3 clinical trial (NCT03141580) evaluating the efficacy of transdermal buprenorphine patches for postoperative pain management following arthroscopic rotator cuff repair. The regimen typically involves the oral administration of diclofenac (75 mg every 12 hours) and tramadol (50 mg every 12 hours), with additional tramadol doses available for rescue analgesia. Diclofenac provides anti-inflammatory and analgesic effects by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), thereby reducing the synthesis of prostaglandins. Tramadol provides central analgesia through a dual mechanism: weak agonism of the mu-opioid receptor and inhibition of the reuptake of norepinephrine and serotonin, which enhances descending inhibitory pain pathways.

Other names

Multimodal Oral Scheme-Hospital Italiano de Buenos Aires-postoperative painMultimodal Oral SchemeMultimodal analgesic scheme