After 12 horrible hours of constant nausea and throwing up post surgery due to narcotic pain meds (apparently all the regular narcotic pain meds make me extremely sick) they started giving me tramadol and torodol. 12 hours post rib resection the combo worked great for pain and I continued to take the tramadol for pain management at home for the first week. It made me a little sleepy but no other side effects for me. Personally I loved it!