Pantea Ramezannezhad
1 
, Mahmoud Hashemzaei
2 , Zohreh Pajohesh
3 , Khadijeh Saravani
4* , Omid Bameri
51 Clinical Biochemistry Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Department of Pharmacology and Toxicology, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
3 Faculty of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
4 Department of Forensic Medicine and Toxicology, Zabol University of Medical Sciences, Zabol, Iran
5 Department of Emergency Medicine, Zabol University of Medical Sciences, Zabol, Iran
Abstract
Tramadol, is frequently misused and leading to an increase in cases of overdose and poisoning worldwide. This study aimed to investigate the clinical and paraclinical consequences of tramadol poisoning and related factors. This was a retrospective study performed on patients with acute tramadol poisoning who were referred to the Amir Al-Momenin Hospital Emergency Department, Zabol, during 2019-2020. Patients’ socio-demographic information and clinical and paraclinical manifestations were collected in a predesigned checklist. Overall, 71 subjects were included in this study. The mean dose of tramadol was 640.14 ± 521 mg. Seizures occurred in 17 subjects that were not dose-dependent. In patients who died or were in a coma, pH, bicarbonate (HCO3 ), and oxygen saturation (O2 sat) levels decreased, while PCO2 levels increased significantly (P < 0.05). The dose of tramadol used in the poisoning of this substance played no role in the course of the disease and the prognosis of patients, but low pH, HCO3 , O2 sat, and high CO2 pressure could be related to the outcome of these patients.