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    Post-operative pain with difficult control, is a reality that can occur in patients undergoing laparoscopic cholecystectomy, it is good comprehensively assess the patient and give a painkiller scheme that ensures the absence of pain. This is an Open Access article published and distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. To compare the analgesic efficacy of tramadol-ketoprofen over a control group in three management schemes in infusional therapy; to control the painful entity (shoulder pain post-laparoscopy surgery). Clinical trial non-randomized; Group I (n = 15) managed with ketorolac 1mg/kg; Group II (n = 12) ketoprofen 100mg; Group III (n = 14) ketoprofen 50 mg plus tramadol 50 mg and Group IV (n = 15) ketoprofen 100 mg plus tramadol 100 mg. The variability analyzed was: Pain, pain bailouts, side effects and patient satisfaction. The highest intensity of pain was found in Group I (conventional) , unlike Group II and III where the predominant category was mild pain, the Group IV presents minimal pain events; 98% significance of p Introduction: Post-operative pain with difficult control, is a reality that can occur in patients undergoing laparoscopic cholecystectomy, it is good comprehensively assess the patient and give a painkiller scheme that ensures the absence of pain. Objective: To compare the analgesic efficacy of tramadol-ketoprofen over a control group in three management schemes in infusional therapy; to control the painful entity (shoulder pain post-laparoscopy surgery). Available dosage forms include liquids, syrups, drops, elixirs, effervescent tablets and powders for mixing with water, capsules, tablets including extended-release formulations, suppositories, compounding powder, and injections. Its use during lactation is also generally advised against, but a small trial found that infants breastfed by mothers taking tramadol were exposed to about 2.88% of the dose the mothers were taking. No evidence of this dose having a harmful effect on the newborn was seen. On September 21, 2015, the FDA started investigating the safety of tramadol in use in persons under the age of 17. The investigation was initiated because some of these people have experienced slowed or difficult breathing. These include both symptoms typical of opioid withdrawal and those associated with serotonin–norepinephrine reuptake inhibitor withdrawal; symptoms include numbness, tingling, paresthesia, and tinnitus.... in many cases of tramadol dependence, a history of substance abuse is present... the evidence for physical dependence was considered minimal.

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