 Tramadol is an effective postoperative analgetic, combining mainly μ-opioid and monoaminerg actions with good clinical effect in treating somatic and visceral pain12,13. The postoperative use of tramadol after Caesarean is insufficiently evaluated. Studies evaluate a short period of 614 or 815 hours postoperatively. Metaanalysis sum up a mix of non-gynaecological and gynaecological data together. Edwards et al. 2002 used data from 7 unpublished randomized, double-blind, placebo controlled trials assessing tramadol and acetaminophen with dental, gynaecological and orthopaedic patients15. Moore et al. 199616 used 18 primary trials for data collection, from which only one had been published Sunshine et al. 199214. Thus clear statement of tramadol after Caesarean section is not possible. 