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COVID is an emerging, rapidly evolving situation. Objectives: The purpose of this study was to compare the analgesic efficacy and tolerability of opioids hydrocodone and tramadol in the relief of cancer pain. Methods: One hundred and eighteen patients with chronic cancer pain participated in a double-blind, randomized controlled trial. Sixty-two patients received hydrocodone and 56 patients received tramadol. Tramadol produced more mild side effects than hydrocodone.

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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 tramadol chlorhydrate 200 mg 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.