Background:Multimodal pain management,combining ana[gesics of differentmode of action aims to minimize occurrence of side effects stillproviding safe and efficacious pain management.Objective:To evaluate the efficacy of a single dose ULTRACETTM (tramado7paracetamot),anaLgesic combination of tramadoVparacetamol forpostoperative pain after breast mass excision, compare withplacebo,one tab[et(tramadol/ paracetamol 37 .5/325 mg),twotabl.et(tramado7 paracetamol 7 5/650 mg).MateriaI and methods: Prospective cohort study was conducted in ninety patients whoundergoing breast mass excision under general anesthesia. Aftersurgery the patients were randomized to three groups of 30 patientseach, placebo ,one tablet and two tablets of tramadol/paracetamo[. numerica[ rating scaLe (NRS), morphine consumptionand side effects were recorded at 1,4,8 hr after surgery.Resutts:NRS and morphine consumption were significantly lower in 1,4 hr.in TP1 group whereas TP2 group significant[y [ower in 1,4,8 hr.compare with placebo (p value < 0.05).Adverse effects were simiLarin alL groups.Conctusion:post operative pain, muLtimodaI anaLgesia, ULTRACETTM', tramadoL,paracetamol, breast mass excision.