International Journal of Preventive Medicine (Int J Prev Med)2008-780210102020020921742174ENDepartment of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, IsfahanDepartment of Clinical Toxicology, Isfahan University of Medical Sciences, IsfahanDepartment of Epidemiology and Biostatistics, Health School, Isfahan University of Medical Sciences, IsfahanIsfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, IsfahanDepartment of Epidemiology and Biostatistics, Health School, Isfahan University of Medical Sciences, IsfahanNoncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa20200205<p><span class="fontstyle0"> </span><span class="fontstyle2">Many studies have focused on the relationship between naloxone and seizure<br />in tramadol poisoning but the results are in conflict. We performed a meta‑analysis study to see whether naloxone prevents or increase the risk of seizure in tramadol poisoning. </span><span class="fontstyle2">Bibliographic literature searches were conducted in the ISI Web of Science, Excerpta Medica Database (EMBASE), PubMed, and Cochrane from January 1990 to December 2017 for relevant articles. Pooled data were analyzed by calculating odds ratios (ORs) with 95% confidence intervals (CIs). The outcome includes seizure. To investigate the publication bias, Begg’s and Egger’s tests were used along with funnel plot as a graphical test. </span><span class="fontstyle2">Seven studies met the inclusion criteria. The meta-analysis showed </span><span class="fontstyle3">I</span><span class="fontstyle2" style="font-size: 5pt;">2</span><span class="fontstyle2">, 27%, (</span><span class="fontstyle3">P </span><span class="fontstyle2">value, 0.23) indicating no significant heterogeneity. As a result, using the fixed effect, the OR was 1.14 (95% CI = 0.60–2.18, </span><span class="fontstyle3">P </span><span class="fontstyle2">value, 0.69) which was not significant, means naloxone did not increase the risk of seizure. </span><span class="fontstyle2">Naloxone therapy did not increase the risk of seizure significantly in the treatment of acute tramadol poisoning. We suggest considering the risk/benefit when administration naloxone, especially for the seizure risk factors including previous history of seizure, tramadol misuse, and co-ingestion.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;">Keywords: </span><span class="fontstyle3">Meta‑analysis, naloxone therapy, poisoning, review, tramadol overdose</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2174http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2174/717717970