Effects of Intravenous Lipid Emulsion Administration in Acute Tramadol Poisoning: A Randomized Controlled Trial

Effects of Intravenous Lipid Emulsion Administration in Acute Tramadol Poisoning: A Randomized Controlled Trial

Authors: Amir Hossein Behnoush, Nafiseh Alizadeh, Mahdi Emami, Elham Bazmi, Yousef Alimohamadi, Behnam Behnoush

Published in: Journal of Emergency Medicine, 2023 November 8

Conclusions:

ILE administration appears beneficial in managing tramadol poisoning, particularly in improving consciousness levels, reducing hospitalization duration, and lowering seizure rates. These findings support the use of ILE in emergency department settings for tramadol toxicity cases, although further research is needed to solidify these recommendations.

Methods:

  • Design: Double-blind, randomized controlled trial.
  • Setting: Poisoning center in Tehran, Iran.
  • Participants: 120 patients with pure tramadol poisoning and a Glasgow Coma Scale (GCS) score ≤ 12.
  • Intervention: Patients were randomly assigned to receive either ILE 20% or 0.9% saline (control) after admission and primary stabilization.
  • Measurements: Vital signs, GCS score, hospitalization duration, and rate of seizure occurrence were documented and analyzed.

Results:

  • Participants: Average age 25.3 years, 70% male, with no significant difference in tramadol ingestion dose between groups.
  • GCS Improvement: The ILE group showed a higher level of consciousness post-treatment (median GCS score 12 vs. 10 in controls; p = 0.03).
  • Hospital Stay: Shorter in the ILE group (median 2 days vs. 4 days in controls; p < 0.01).
  • Seizures: Occurred less frequently in the ILE group (16/60 vs. 30/60 in controls; p < 0.01).
Behnoush, A.H., Alizadeh, N., Emami, M., Bazmi, E., Alimohamadi, Y. and Behnoush, B., 2023. EFFECTS OF INTRAVENOUS LIPID EMULSION ADMINISTRATION IN ACUTE TRAMADOL POISONING: A RANDOMIZED CONTROLLED TRIAL. The Journal of Emergency Medicine.
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