Journal of Clinical Toxicology
Open Access

Abstract

Assessment of the Role of Naloxone in the Prognosis of Tramadol Intoxicated Patients

Rania Hussien and Mahmoud Khairat Elguindy

Background: Tramadol is opioid analgesic which acts on the central nervous system. Most of clinicians may not routinely consider naloxone for tramadol cases because of risks of inducing seizures.

This study aims to evaluate the effect of naloxone in the prognosis of patients with tramadol intoxication and its role in inducing seizures.

Methods: This study included both prospective and retrospective studies. The prospective study involved 30 patients with tramadol intoxication admitted to the poison control center during the year of 2015 who received naloxone while the retrospective study involved 30 patients with tramadol intoxication admitted to the poison control center during the years of 2011-2012 who didn't receive naloxone.

Results: The studied patients were in the age 16-60 years range with male predominance (75%). Most of patients (65%) were tramadol addict. The mean delay time was 3.32 ± 1.50 hours while the dose of ingested tramadol among studied patients was 1439.29 ± 804.49 mg. The most common symptom on admission among studied patients was sweating (66.7%), cyanosis (61.7%) and bradypnea (60%). The seizure was significantly lower in naloxone group (6.6%) when compared with the non naloxone group (50%). Death occurred in 23.3% of the non naloxone group and only 3.3% of naloxone group.

Conclusion: The incidence of seizure was lower in patients with tramadol toxicity who given naloxone which means that naloxone not precipitate seizure in patients with tramadol toxicity as what was thought by the majority of previous studies.