Answer to the Letter to the Editor of LJ Castro-Alves et al. concerning “Comparative study of the efficacy of transdermal buprenorphine patches and prolonged-release tramadol tablets for postoperative pain control after spinal fusion surgery: a prospective, randomized controlled non-inferiority trial” by HJ Kim et al. (2017) Eur Spine J;26:2961–2968
We are grateful for these excellent comments. Our answers are below:
Thank you for your excellent comments. We agree with this opinion. In this clinical trial, however, we did not use any intraoperative analgesics.
We appreciate this comment. For postoperative pain control, patient-controlled analgesia (PCA) and buprenorphine/tramadol were used and any other different analgesics were not used.
Thank you for this excellent comment. Below is the protocol in the tramadol group.
“In the Tramadol group, a sustained action oral tramadol dose of 150 mg/day was provided 36 h postoperatively. The possible doses of tramadol tablets were 150, 200, 250, and 300 mg/day. Supplementary acetaminophen was available throughout the study as rescue medication.”
As you mentioned, titration was allowed for patient’s safety. However, the strength of 120 mg/day of tramadol is the equivalent to that of 7-day patch of 5 mcg/h. Therefore, titration would not influence the present results.
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Conflict of interest
The author declare that there is no conflict of interest.