TRAMADOL is a narcotic-like pain reliever. It is a synthetic, centrally acting analgesic drug with two distinct, synergistic mechanisms of action. Usually, TRAMADOL is used to manage moderate to severe surgical pain but it has shown anti-shivering effect in some setting. TRAMADOL is a weak opioid agonist and an inhibitor of monoamine neurotransmitter reuptake. It could inhibit the reuptake of 5-hydroxy tryptamin, Norepinephrine, and Dopamine [1]. . .

Background: TRAMADOL is a widely prescribed analgesic and due to its opioid-like effects, the potential for abuse of TRAMADOL is noticeable. Besides, the complications of TRAMADOL abuse have become a public health concern. This study aimed to investigate the affecting factors on the seizure, as one of the most common complications of TRAMADOL consumption. Methods: A total number of 64 patients from 315 patients who were referred to Sina Hospital, Tabriz, Iran because of TRAMADOL toxicity were included in this 9 months cross-sectional retrospective study. Results: There were 52 males and 12 females in the study. The seizure happened in 53. 1% of the subjects and the Mean± SD time between TRAMADOL consumption and seizure was 5. 9± 7. 36 hours. There was no significant association between seizure and sex, age, the dose of TRAMADOL, and previous TRAMADOL consumption history. A significant association was seen between the dose of TRAMADOL and the time of seizure. Conclusion: Seizure that happens due to TRAMADOL overdose is not dependent on sex, age, and previous history of TRAMADOL consumption. As the dose of TRAMADOL is higher, the seizure happens later. More research is needed to understand why the seizure occurs later in higher doses.

This study aimed to evaluate the shoulder dislocation following TRAMADOL-induced seizure and its potential difference with other shoulder dislocations. We evaluated six cases that used TRAMADOL tablets and some of them had a history of seizure. All of the cases had shoulder dislocation. According to the findings, TRAMADOL use and TRAMADOL-induced seizure may increase the risk of shoulder dislocation.