Kazemifar Amir Mohammad, Yazdi Zohreh, Bedram Abbas, Mahmoudi Javad, Ziaee Mojtaba
Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Arch Acad Emerg Med. 2021 Feb 20;9(1):e20. doi: 10.22037/aaem.v9i1.1070. eCollection 2021.
There are numerous studies on the efficacy of intralipid emulsion (ILE) in various xenobiotic toxicities. 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 with acute tramadol intoxication, who referred to Booali Hospital in Qazvin. Patients were randomly assigned to 2 groups. 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 the groups.
80 patients who abused tramadol and met the study criteria were randomly assigned to either the intervention (40 cases) or the control (40 cases) group. Seizure occurred in 44 (56%) patients before admission to the emergency department. There were not any statistical differences between the groups regarding sex distribution (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-hospital seizure occurred in 15 (18.75%) cases (all in the control group; p < 0.001). The mean duration of admission was 2.01 ± 1.13 days in the control group and 2.15 ± 1.04 days in the intervention group (p = 0.6). The number needed to treat for ILE to prevent tramadol-induced seizure was 2.7 (37.5% absolute risk reduction).
The findings of this study supported ILE administration, as an adjunct to standard antidote protocols, in tramadol intoxication to prevent tramadol-induced seizures.
关于脂质乳剂（ILE）对各种外源性毒物中毒的疗效已有大量研究。本研究旨在评估ILE作为曲马多诱发癫痫解毒剂的潜在作用。
开展了一项单盲临床试验，以确定ILE对转诊至加兹温布阿利医院的急性曲马多中毒患者的疗效和安全性。患者被随机分为两组。对照组接受标准治疗，干预组在标准治疗基础上额外接受20%的脂质乳剂（ILE）。比较两组住院期间癫痫发作的情况。
80名滥用曲马多并符合研究标准的患者被随机分为干预组（40例）或对照组（40例）。44名（56%）患者在进入急诊科之前就已发生癫痫发作。两组在性别分布（p = 0.513）、平均年龄（p = 0.19）、生命体征（p < 0.05）、实验室检查结果（p < 0.05）、曲马多平均滥用剂量（p = 0.472）以及院前癫痫发作情况（p = 0.7）方面均无统计学差异。住院期间，15例（18.75%）患者发生癫痫发作（均在对照组；p < 0.001）。对照组的平均住院时间为2.01±1.13天，干预组为2.15±1.04天（p = 0.6）。预防曲马多诱发癫痫发作所需的ILE治疗人数为2.7（绝对风险降低37.5%）。
本研究结果支持在曲马多中毒时使用ILE作为标准解毒方案的辅助手段，以预防曲马多诱发的癫痫发作。
