DISCUSSION
nausea, drowsiness or vomiting, pain, dizziness, ’ pain
ADVERSE EFFECTS, ADVERSE EFFECT
This study demonstrates that highly trained cyclists can maintain a significantly higher power output and complete a competitive TT in a significantly faster time following acute ingestion of 100 mg of fast-acting soluble tramadol. Tramadol reduced the perception of effort for a given power output but had no discernible impact on pain intensity whilst cycling. Consequently, hypothesis 1 (H1) was accepted and hypothesis 2 (H2) was partially accepted. The results from this study suggest that tramadol is a performance-enhancing drug in time trial cycling and raises questions pertaining its fair use in competition.With tramadol, participants’ mean improvement in TT completion time was 1.3%, which was driven by a 9 W higher mean power output over the TT. For a self-paced time trial in a group of highly trained cyclists, this is a significant ergogenic effect. For context, in this cohort of 25 highly trained cyclists a rider with a 1.3% faster TT could change the medalling positions, or take a rider placed in the middle of the third quintile into the middle of the second quintile.The majority (19 from 25) of participants produced a faster TT in the tramadol condition, and aspects of the Holgado (Three of the participants in the current study expressed and displayed adverse effects in the tramadol condition after the TT completion. For one participant these effects were mild (nausea, mild dizziness), whereas for two these were more pronounced (drowsiness or vomiting). It is worth noting that these side effects did not seem to significantly impair their performance (or the ergogenic effect outweighed the impact of the adverse effect), as two of these participants still produced a faster time in the tramadol condition. This is in contrast to the Bejder study (In the current study, the pre-load trial served to, The correlations between the psychometric tests and the differences in completion time are intriguing. They suggest a relationship between the ergogenic effect of tramadol and participants’ pain resilience score, and specifically their cognitive/affective positivity score. In the current cohort, a participant with a higher self-reported pain resilience, and higher perceived ability to regulate emotions and cognition relating to pain was more likely to obtain an ergogenic effect from tramadol. Although this does not demonstrate causation and cannot explain the relationship, it may be that participants who attributed more importance on the impact of pain on exercise performance received an increased benefit for an intervention that mitigated the pain associated with exercise.