Evaluation of Methadone Poisoning in Pediatric Emergency Department, Gorgan, North of Iran (2011-19)

Poisoning is one of the most common causes of emergency room visits. Opioids and methadone are the causes of unintentional poisoning, especially in children, who have a high burden of emergency referrals in children's hospitals. This study was performed to evaluate methadone poisoning in the pediatric emergency department in Gorgan, North of Iran.

This cross-sectional study was performed on the records of patients admitted (85 boys and 70 girls) cases due to methadone poisoning in Taleghani Hospital in Gorgan, North of Iran during 2001-19 .The symptoms of patients and the costs of treatment and care of patients were analyzed.

A total of 258 cases of poisoning were registered, of which 155 (60%) were methadone poisoning. Poisoning occurred for 136 cases (87.8%) with methadone syrup and for 19 cases (12.2%) with methadone tablets. The mean of age and age range was 47.94±36.25 months and 4-156 months, respectively. The mean and standard deviation of the time interval from consumption to the time of admission was 164.84±160.11 minutes and the maximum and minimum time interval were 720 and 15 minutes, respectively. 34 cases (22%) were conscious, 110 cases (71.5%) had impaired level of consciousness, seven cases (4.5%) presented with cardio respiratory arrest and three patients (1.9%) presented with seizures and one child (0.1%) was dead. Moises, bradypnea and apnea were seen in 78 (51.3%), 62 (40%) and 7 (4.5%) children, respectively. Six children had a history of hospitalization due to methadone poisoning, of which 2 were the day before, 3 were the month before, and 1 was 2 years ago. Two children were addicted. The mean±SD of the number of hospitalization days were 2.39±1.57 and the minimum and the maximum were 1 and 9 days. The mean±SD of hospitalization cost was 7642249±5341725 Rials. The average consumption of naloxone was 6.83± 10.41mg and the minimum and the maximum were one and 68 milligrams.

The results of this study showed that meiosis is not observed in half of children with methadone poisoning. Therefore, it is recommended that in the case of children with impaired level of consciousness or seizures without a specific reason; methadone poisoning should be concerned as a differential diagnosis by medical staff and this diagnosis should not be ignored only in the absence of meiosis or respiratory dysfunction.