曲马多诱发癫痫患者的动脉血气分析；一项横断面研究。

Arterial Blood Gas Analysis of Patients with Tramadol-induced Seizure; a Cross Sectional Study.

作者信息

Dadpour Bita, Alizadeh Anahita, Vahabzadeh Maryam, Mousavi Seyed Reza, Moshiri Mohammad, Ataee Zahra, Mostafazadeh Babak

机构信息

Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Toxicological Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Arch Acad Emerg Med. 2020 Mar 1;8(1):e14. eCollection 2020.

PMID:32259113

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7130435/

Abstract

INTRODUCTION

Tramadol is an active analgesic drug that is commonly used to treat moderate to severe pain. The present study aimed to assess the arterial blood gas (ABG) analysis of patients with tramadol-induced seizure (TIS).

METHODS

This prospective cross-sectional study was performed on 50 TIS cases that were referred to emergency department within a maximum of one hour after their last episode of seizure. The results of ABG analysis on admission were collected and their association with dosage and time interval between ingestion and admission was assessed.

RESULTS

50 cases with the mean age of 35.10 ± 9.62 years were studied (80.0% male). The mean dosage of ingestion was 1122.00 ± 613.88 (400 to 3000) mg and the mean time interval between ingestion and admission was 7.16 ± 2.18 hours. ABG analysis on admission showed that 49 (98.0%) patients had pH < 7.35 and PaCO2 > 45 mmHg (respiratory acidosis). There was a significant association between ingestion to admission time interval and both PaCO (r = -0.330, p = 0.019), and PaO (r = 0.303, p = 0.032). The dose of ingestion was negatively associated with respiratory rate (r = -0.556, p = 0.001), arterial pH (r = -0.676, p = 0.001), and PaO (r = -0.514, p = 0.001), but was positively associated with PaCO (r = 0.461, p = 0.001). Higher doses of tramadol led to more severe hypercapnia and need for intubation (OR = 1.12, 95% CI: 0.88 - 1.26; p = 0.045). 5 (10.0%) cases needed mechanical ventilation. All patients improved after supportive care with no in-hospital death.

CONCLUSION

Based on the findings, 98% of TIS cases had respiratory acidosis. Higher doses of ingested drug and longer time interval between ingestion and admission were associated with severity of ABG disturbances.

摘要

引言

曲马多是一种常用的有效镇痛药，用于治疗中度至重度疼痛。本研究旨在评估曲马多诱发癫痫（TIS）患者的动脉血气（ABG）分析。

方法

本前瞻性横断面研究对50例TIS患者进行，这些患者在最后一次癫痫发作后最多1小时内被送往急诊科。收集入院时ABG分析结果，并评估其与剂量以及摄入与入院之间的时间间隔的关系。

结果

研究了50例患者，平均年龄为35.10±9.62岁（80.0%为男性）。平均摄入剂量为1122.00±613.88（400至3000）mg，摄入与入院之间的平均时间间隔为7.16±2.18小时。入院时的ABG分析显示，49例（98.0%）患者的pH<7.35且PaCO2>45 mmHg（呼吸性酸中毒）。摄入至入院的时间间隔与PaCO（r = -0.330，p = 0.019）和PaO（r = 0.303，p = 0.032）均存在显著相关性。摄入剂量与呼吸频率（r = -0.556，p = 0.001）、动脉pH（r = -0.676，p = 0.001）和PaO（r = -0.514，p = 0.001）呈负相关，但与PaCO（r = 0.461，p = 0.001）呈正相关。较高剂量的曲马多导致更严重的高碳酸血症和插管需求（OR = 1.12，95% CI：0.88 - 1.26；p = 0.045）。5例（10.0%）患者需要机械通气。所有患者在支持性治疗后均有改善，无院内死亡。