Effects of Intravenous Lipid Emulsion on Tramadol-Induced Seizure; a Randomized Clinical Trial

Introduction:

There are numerous studies on the efficacy of intralipid emulsion (ILE) in various xenobiotictoxicities. This study aimed to evaluate the potential role of ILE as an antidote in tramadol-induced seizure.

A single-blind clinical trial was undertaken to establish the efficacy and safety of ILE in patients withacute tramadol intoxication, who referred to Booali Hospital in Qazvin. Patients were randomly assigned to 2groups. The Control group received standard care while the intervention group received intralipid emulsion(ILE) 20% in addition to the standard care. The occurrence of in-hospital seizure was compared between thegroups.

80 patients who abused tramadol and met the study criteria were randomly assigned to eitherthe intervention (40 cases) or the control (40 cases) group. Seizure occurred in 44 (56%) patients before admis-sion to the emergency department. There were not any statistical differences between the groups regarding sexdistribution (p=0.513) and mean age (p=0.19), presenting vital signs (p < 0.05), laboratory findings (p < 0.05),and mean abused dose of tramadol (p = 0.472) as well as occurrence of prehospital seizure (p = 0.7). In-hospitalseizure occurred in 15 (18.75%) cases (all in the control group; p < 0.001). The mean duration of admission was2.01±1.13 days in the control group and 2.15±1.04 days in the intervention group (p = 0.6). The number neededto treat for ILE to prevent tramadol-induced seizure was 2.7 (37.5% absolute risk reduction).

Thefindings of this study supported ILE administration, as an adjunct to standard antidote protocols, in tramadolintoxication to prevent tramadol-induced seizures.