Evaluation of neurological symptoms of acute tramadol poisoning and its relationship with laboratory findings

Abstract

Introduction: Tramadol is a unique opioid and the most prescribed opioid worldwide. Tramadol-related overdose and death have been increased in several countries. Due to the high level of tramadol use, misuse, and overdose in Iran, and considering the cost and time spent doing laboratory tests for all patients, this study aimed to investigate the possible relationship between changes in laboratory findings of patients poisoned by tramadol and their neurological manifestations to evaluate the need for these tests. Methods: This was a cross-sectional descriptive study of patients with acute tramadol poisoning who were referred to the Emergency department of Sina hospital, Tabriz, Iran from March 2020 to March 2021. Lab tests taken from the patient in the emergency department were recorded. Meanwhile, the patients’ neurological symptoms were noted. And demographic information of patients was collected in a predesigned checklist and was analyzed by IBM® SPSS® 20.0 release software. Results: A total of 95 patients including 76.8% male and 23.2% female with an average age of 28.26±10.57 were admitted to the emergency department. The most common symptoms of neurological impairment experienced by patients were seizure (32.6%) and decreased level of consciousness (38.8%). There was no relationship between the neurological symptoms of tramadol poisoning with neither arterial blood gas characteristics nor hematological factors (P>0.05). Conclusion: The neurological manifestations of tramadol poisoning were not related to arterial blood gas characteristics such as PH, PCO2, PO2, and HCO3−. Also, there was no relationship between hematological factors including white blood cell (WBC), red cell distribution width (RDW), platelets (Plt), sodium (Na), potassium (K) and blood sugar (BS), and neurological symptoms caused by acute tramadol poisoning. Therefore, requesting these tests during tramadol poisoning should be reconsidered.

Keywords

• hematological factors
• laboratory tests
• neurological finding
• seizure
• tramadol