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Tramadol is a synthetic opioid with a structure of -trans-2 di-methylaminomethyl 1-m-methox-yphenyl cyclohexanol hydrochloride. Tramadol has minimal respiratory depressant effect, probably because of its multiple routes of action. If the patient spontaneously complained of pain and the VAS score was over 5 cm, a second dose of the drug was given epidurally.
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