Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Forensic Medicine - Toxicology

BACKGROUND: Tramadol is a centrally acting synthetic opioid analgesic agent that is widely used. METHODS: This is a retrospective cross sectional study conducted for the pediatric age group (under 18 years old) admitted to NECTR (National Environmental and Clinical Toxicological Research Center) from January 2014 to December 2014 with a history of acute tramadol or other drug of abuse toxicity either alone or combined toxicity of tramadol and one of them. RESULTS: A total of 135 cases, the number of cases used tramadol only were 57 cases, those used combined tramadol and other drugs were 13 cases. Cannabis only intoxicated cases were 50 cases, Alcohol only intoxicated cases were 13 cases and only 2 cases were admitted with benzodiazepine toxicity. The majority of the cases were males and most of the cases came from Giza.the age group (from 2 to 11 years) represented the majority of tramadol only intoxicated cases (64.9%) while infant and toddler (28 days to 23 month) were the majority of cannabis intoxicated cases but in combined toxicity cases, alcohol and benzodiazepines intoxicated patients, the age group (12 to 18 years) represented the majority of the cases. The majority of the cases ingested the drug accidently except in benzodiazepine intoxicated cases whereas all the cases took it in suicidal attempts. The most common administered dose of tramadol was 225mg. Coma and dyspnea were frequent among the cases while seizures were rare. The majority of the cases didn{u2019}t need mechanical ventilation and improved on discharge. CONCLUSION: Acute tramadol toxicity in children is common and can cause coma, dyspnea and less frequently seizures

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