title: The detection and identification of quaternary nitrogen muscle relaxants in biological fluids and tissues by ion-trap LC-ESI-MS.
abstract: Quaternary nitrogen muscle relaxants pancuronium, rocuronium, vecuronium, gallamine, suxamethonium, mivacurium, and atracurium and its metabolites were extracted from whole blood and other biological fluids and tissues by using a solid-phase extraction procedure. The extracts were examined by using high-performance liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS). The drugs were separated on a ODS column in a gradient of ammonium acetate buffer (pH 5.0) and acetonitrile. Full-scan mass spectra of the compounds showed molecular ions, and MS-MS spectra showed fragments typical of the particular compounds. LC-ESI-MS allowed an unequivocal differentiation of all muscle relaxants involved. The method was applied in a case of rocuronium and suxamethonium administration in a Caesarian section and in a case of intoxication by pancuronium injection. In both cases, the administered drugs could be detected and identified in the supplied samples.
authors.affiliation: The Netherlands Forensic Institute, Department Toxicology, Rijswijk.
authors.forename: C H M
authors.initials: CH
authors.lastname: Kerskes
authors.forename: K J
authors.initials: KJ
authors.lastname: Lusthof
authors.forename: P G M
authors.initials: PG
authors.lastname: Zweipfenning
authors.forename: J P
authors.initials: JP
authors.lastname: Franke
mesh_terms: D000328:Adult; D000732:Androstanols / Q000032:analysis / Q000506:poisoning; D001646:Bile / Q000737:chemistry; D001826:Body Fluids / Q000737:chemistry; D002021:Buffers; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D007202:Indicators and Reagents; D008099:Liver / Q000737:chemistry; D008297:Male; D013058:Mass Spectrometry; D009125:Muscle Relaxants, Central / Q000032:analysis* / Q000097:blood / Q000652:urine; D009467:Neuromuscular Depolarizing Agents / Q000032:analysis; D003473:Neuromuscular Nondepolarizing Agents / Q000032:analysis / Q000506:poisoning; D017672:Nitrogen Compounds / Q000032:analysis* / Q000097:blood / Q000652:urine; D010197:Pancuronium / Q000032:analysis / Q000506:poisoning; D011041:Poisoning / Q000175:diagnosis; D011247:Pregnancy; D012015:Reference Standards; D000077123:Rocuronium; D021241:Spectrometry, Mass, Electrospray Ionization; D013390:Succinylcholine / Q000032:analysis / Q000506:poisoning
chemical_list: D000732:Androstanols; D002021:Buffers; D007202:Indicators and Reagents; D009125:Muscle Relaxants, Central; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D017672:Nitrogen Compounds; D013390:Succinylcholine; D010197:Pancuronium; D000077123:Rocuronium