Intrathecal tramadol may cause respiratory depression

  • Waqas Alam Department of Anesthesia & Intensive Care, PNS Shifa Hospital, Karachi, (Pakistan)
  • Mobasher Ahmad Saeed Department of Anesthesia & Intensive Care, PNS Shifa Hospital, Karachi, (Pakistan
  • Khan Muhammad Yaqub Department of Anesthesia & Intensive Care, PNS Shifa Hospital, Karachi, (Pakistan)
Keywords: Tramadol, Respiratory depression, Intrathecal, Opioid overdose

Abstract

Opioids such as morphine and fentanyl have been used in neuraxial anesthesia to prolong the analgesic effects since long, but these have frequently been associated with few adverse effects e.g. nausea, vomiting, pruritus and rarely respiratory depression. Tramadol has also been used in epidural as well as spinal anesthesia, and respiratory depression has not been reported with its intrathecal use. We present a case in which 20 mg of intrathecal tramadol produced signs of opioid overdose including respiratory depression. The side effects were reversed with naloxone confirming our suspicion that these were caused by tramadol. We recommend adequate monitoring and vigilance for tramadol as is used for other intrathecal opioids.

Published
01-20-2019
How to Cite
Alam, W., Saeed, M. A., & Yaqub, K. M. (2019). Intrathecal tramadol may cause respiratory depression. Anaesthesia, Pain & Intensive Care, 87-89. Retrieved from https://mail.apicareonline.com/index.php/APIC/article/view/143
Section
Case Reports