Acute Delirium due to Parenteral Tramadol

Tramadol is a widely used medication by physicians and is held to be a safe analgesic. It has been claimed to be helpful in the elderly and hepatic and renally compromised subjects. We would like to report a case of delirium in a middle-aged female with acute pain abdomen on tramadol while being treated in the surgical unit. The patient developed alteration in the level of consciousness and cognitive deficits following injectable dose of tramadol. She was diagnosed as a case of tramadol-induced delirium. The patient improved spontaneously after stoppage of tramadol injection. The probable mechanism for development of tramadol-induced delirium is discussed along with clinical implications.