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Acute intoxication by tramadol: Report of a clinical case

Abstract:

Tramadol is a synthetic opioid whose mechanism of action is twofold: it stimulates the μ, δ and κ receptors; and it also reduces the reuptake of norepinephrine and serotonin. Its adverse effects include nausea, vomiting, sweating, dizziness, sedation, and hypertension. During its historical use it has been contraindicated in children due to the harmful effects it can have on them; Accidental poisoning by this type of opioid is very common in emergency services and in pediatric patients it can even lead to death, which is why the objective of this work is to analyze tramadol poisoning presented in a 4-month-old patient of age, at the Alfredo Noboa Montenegro Hospital, to establish timely diagnostic and therapeutic measures. As a result, the case of a 4-month-old patient who had been accidentally administered tramadol was presented; she was admitted with a clinical picture of drowsiness, accompanied by apparent respiratory distress, hypotension, miosis, tachycardia, and low-grade fever. The tests performed showed leukopenia, elevated Aspartate Transaminase, and respiratory acidosis. The patient presented all the characteristic signs of the opioid syndrome, the treatment consisted of gastric lavage, oxygen the-rapy and administration of Naloxone.