{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T19:43:49Z","timestamp":1789069429404,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Introduction: We conducted a head-to-head comparison of step 2 (tramadol) and step 3 (oxycodone) of the WHO pain ladder in older adults with moderate to severe acute locomotor pain. Materials and methods: Multi-center prospective randomized study. Patients were 70 years or older, admitted to the acute geriatric ward of three hospitals, suffering from acute moderate to severe locomotor pain, and opioid-naive. Patients were randomized into two treatment groups: tramadol versus oxycodone. The Consort reporting guidelines were used. Results: Forty-nine patients were included. Mean numeric rating scale (NRS) decreased significantly between day 0 and 2 of the inclusion in both groups. A sustained significant decrease in mean NRS was seen at day 7 in both groups. Nausea was significantly more prevalent in the tramadol group, with a trend towards a higher prevalence of delirium and falls and three serious adverse events in the same group. Conclusions: Opioid therapy may be considered as a short-term effective treatment for moderate to severe acute locomotor pain in older adults. Oxycodone may possibly be preferred for safety reasons. These results can have implications for geriatric practice, showing that opioids for treatment of acute moderate to severe locomotor pain in older patients are effective and safe if carefully monitored for side effects. Opioid therapy may be considered as a short-term treatment for moderate to severe acute locomotor pain in older adults, if carefully monitored for (side) effects, while oxycodone may possibly be preferred for safety reasons. These results can have implications for daily practice in geriatric, orthopedic, and orthogeriatric wards, as well as in terminal care, more precisely for the treatment of moderate to severe acute locomotor pain in older adults.<\/jats:p>","DOI":"10.3390\/geriatrics9020046","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T10:04:17Z","timestamp":1712311457000},"page":"46","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Short-Term Opioid Treatment of Acute Locomotor Pain in Older Adults: Comparison of Effectiveness and Safety between Tramadol and Oxycodone: A Randomized Trial"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2170-2330","authenticated-orcid":false,"given":"Wim Henri","family":"Janssens","sequence":"first","affiliation":[{"name":"Department of Geriatrics, University Hospital Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauwelijn","family":"Verhoestraete","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Hospital Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth D.","family":"Piers","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Hospital Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele J.","family":"Van Den Noortgate","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Hospital Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3161","DOI":"10.2147\/JPR.S184746","article-title":"Epidemiological profiles of chronic low back and knee pain in middle-aged and elderly Japanese from the Murakami cohort","volume":"11","author":"Takahashi","year":"2018","journal-title":"J. Pain Res."},{"key":"ref_2","unstructured":"Olde Rikkert, M.G.M., van Iersel, M.B., and Flamaing, J. (2016). Probleemgeorienteerd Denken in de Geriatie, De Tijdstroom."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.archger.2017.10.019","article-title":"Multimorbidity and health-related quality of life among the community-dwelling elderly: A longitudinal study","volume":"74","author":"Gu","year":"2017","journal-title":"Arch. Gerontol. 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