Which of the following is a contraindication for the use of tramadol?

Tramadol is often used as a pain management option due to its unique mechanism of action, but there are specific populations and circumstances in which its use may be contraindicated. One critical contraindication is the use in individuals under the age of 18, particularly in cases of post-operative pain.

In the scenario provided, the 14-year-old female with post-operative pain represents such a case. The concerns involve the potential for serious side effects, including respiratory depression, and the risk of developing dependence or misuse, which is particularly heightened in younger individuals. The safety profile of tramadol in pediatric patients has not been fully established, leading to recommendations against its use in this population.

In contrast, the other scenarios involve patients who are either experiencing moderate pain or have a history of chronic pain, which typically does not preclude the use of tramadol. Similarly, a healthy adult with a broken arm is likely to be a candidate for tramadol therapy, as it can be effective in managing acute pain resulting from an injury. Therefore, the correct identification of the 14-year-old female as a contraindication aligns with the clinical guidelines regarding tramadol use in pediatric patients.