Summary: Tramadol is a synthetic analgesic with a specific, multidirectional mechanism of action. It is a pure, non-selective, weak agonist of the μ, δ and κ opioid receptors with a particular affinity for the μ receptor. Other mechanisms of analgesic action result from the inhibition of neuronal reuptake of norepinephrine and the intensification of serotonin release. Tramadol is a drug with pleiotropic effects in the pharmacotherapy of pain. It has an analgesic, antihyperalgesic and antisensitizing effect with an additional anxiolytic effect in the treatment of pain.