Abstract
Background: Drug poisoning is the most common type of poisoning in the world. The utilization of tramadol for the management of pain has been identified as a significant contributor to the incidence of poisoning cases. Tramadol poisoning can result in a range of neurological complications, including seizures and a decreased level of consciousness. Tramadol-induced seizures are frequently dose independent and manifest as generalized tonic-clonic seizures. The neurotoxic effects of tramadol are primarily manifested within the initial 24 h period following ingestion, with 84.6% of the seizures occurring within the first six hours. In addition, it has been documented that 15%-35% of the patients with tramadol poisoning have experienced seizures. The present study was undertaken to elucidate the clinical and paraclinical signs and symptoms observed in patients with tramadol poisoning and their correlation with the occurrence of seizures. Methods and Materials: All patients hospitalized due to tramadol poisoning from October 2019 to September 2020 in the poisoning department of Imam Reza Hospital if they met the inclusion criteria were studied. The patients were divided into two groups with and without seizures. The occurrence of seizures was substantiated through the documentation of EMS personnel and the direct observation of the attending physician in the emergency room. Following admission, the patient's blood glucose level was quantified via a glucometer. A blood sample was also obtained for subsequent laboratory evaluation. In the event of any aberrations in blood glucose levels, a re-evaluation was conducted at one-hour intervals using a glucometer. All findings were analyzed using SPSS Version 25 statistical software. The level of significance was set at p < 0.05. Results: A total of 163 patients were included in this study. In 94 patients (57.3%), some degree of consciousness loss and seizures occurred in 69 patients (42.1%). There was a significant relationship between the occurrence of seizures and the increase in blood glucose levels of patients (p=0.031). The findings indicated that 60% of the patients with blood glucose levels exceeding 140 mg/dL experienced seizures. Conclusion: Seizures in tramadol poisoning may be related to the patient's blood glucose levels.