Efficacy and safety of naloxone in the management of postseizure complaints of tramadol intoxicated patients: a self-controlled study

Saidi, Hossein; Ghadiri, Mojtaba; Abbasi, Saeed; Ahmadi, Seyed-Foad

doi:10.1136/emj.2009.083162

Cited by 26 publications

(13 citation statements)

References 9 publications

(10 reference statements)

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“…One randomized controlled study suggested that one single intravenous (IV) 0.8-mg dose of naloxone was responsible for seizurogenic effects in tramadol-overdosed patients [14]. By contrast, another self-controlled study concluded to the efficacy and safety of 0.05 mg naloxone administered IV every 3-5 min after initial resuscitation to manage tramadol-intoxicated patients with postseizure complaints [15]. In addition, tramadol-poisoned children are at risk of apnea and seizures highlighting the necessity to define an efficient and safe antidote to reverse central nervous system (CNS) toxicity, considering the European advice for the treatment of moderate pain in children suggesting limited codeine use and rather tramadol prescription [16,17].…”

Section: Introductionmentioning

confidence: 99%

Is naloxone the best antidote to reverse tramadol-induced neuro-respiratory toxicity in overdose? An experimental investigation in the rat

Lagard

Malissin

Indja

et al. 2017

Clinical Toxicology

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Section: Introductionmentioning

confidence: 99%

Is naloxone the best antidote to reverse tramadol-induced neuro-respiratory toxicity in overdose? An experimental investigation in the rat

Lagard

Malissin

Indja

et al. 2017

Clinical Toxicology

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“…14 In Saidi et al, 43 out of 47 patients over 16 years of age had clinical cerebral state monitor benefits after a naloxone injection. 15 Side effects were minor in this study.…”

Section: Discussionmentioning

confidence: 59%

Accidental tramadol ingestion in children admitted in tertiary care centre

Sruthi

Narendra

2019

Int J Basic Clin Pharmacol

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Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

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“…This study also reported a case of seizure in one patient, immediately after administering naloxone, although the seizure could be the residual effect of Tramadol. In Saidi et al [22], 43 out of 47 patients over 16 years of age had clinical Cerebral State Monitor benefits after a Naloxone injection. Side effects were minor in this study.…”

Section: Discussionmentioning

confidence: 97%

“…Central nervous system depression and hypoventilation can be treated with Naloxone, which accelerates recovery [22]. Some cases of children intoxicated report the use of Naloxone as a diagnosis and treatment with success [10].…”

Section: Discussionmentioning

confidence: 99%

Severe Tramadol Overdoses in Children: A Case Series Admitted to Paediatric Intensive Care Unit

Tanné¹,

Javouhey²,

Millet³

et al. 2016

J Clinic Toxicol

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Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. We reviewed 7 paediatric cases of patients hospitalized in the Intensive Care Unit. We reported unusual hypertonia and chest rigidity leading to ventilator difficulties. None of the children were suspected to be ultra-rapid metabolizers, and one case led to death.Overdoses can lead to death and must maintain practitioners on alert because of the increasing use of tramadol in the paediatric population. The handling of the bottles should be explained to families and Naloxone could be efficient when opioids signs.

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Efficacy and safety of naloxone in the management of postseizure complaints of tramadol intoxicated patients: a self-controlled study

Abstract: Naloxone can be considered in the management of postseizure complaints of tramadol toxicity, but further rigorous studies are needed to provide sufficient evidence to support its routine use.

Cited by 26 publications

References 9 publications

Is naloxone the best antidote to reverse tramadol-induced neuro-respiratory toxicity in overdose? An experimental investigation in the rat

Is naloxone the best antidote to reverse tramadol-induced neuro-respiratory toxicity in overdose? An experimental investigation in the rat

Accidental tramadol ingestion in children admitted in tertiary care centre

Severe Tramadol Overdoses in Children: A Case Series Admitted to Paediatric Intensive Care Unit

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