title: Determination of chronic abuse of the anaesthetic agents midazolam and propofol as demonstrated by hair analysis.
abstract: A 44-year-old female nurse in a department of anesthesiology was found dead at home. An empty bottle of Hypnovel (midazolam 5 mg/5 ml) and a hypodermic syringe were found near the corpse. The nurse was a known abuser of anaesthetic agents for many years. A complete screening for general unknown substances by FPIA, GC/MS, head space GC/MS and HPLC/DAD revealed the simultaneous presence of midazolam, propofol and ethanol in femoral blood. Segmental analysis of a 6-cm-long hair strand revealed the presence of midazolam and propofol in each 2-cm-long segment. Repetitive consumption of the two anaesthetic agents during the last 6 months before the death was therefore demonstrated. These compounds were also detected in pubic and axillary hairs. Self-administration of midazolam and propofol without respiratory assistance and medical control certainly contributed to the death.
authors.affiliation: Institut de Médecine Légale, Strasbourg, France. vincent.cirimele@medecine.u-strasbg.fr
authors.forename: Vincent
authors.initials: V
authors.lastname: Cirimele
authors.forename: Pascal
authors.initials: P
authors.lastname: Kintz
authors.forename: Stephane
authors.initials: S
authors.lastname: Doray
authors.forename: Bertrand
authors.initials: B
authors.lastname: Ludes
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000032:analysis*; D001344:Autopsy / Q000379:methods; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006197:Hair / Q000737:chemistry*; D006801:Humans; D008874:Midazolam / Q000032:analysis*; D015742:Propofol / Q000032:analysis*; D015813:Substance Abuse Detection / Q000379:methods*; D015819:Substance Abuse, Intravenous / Q000473:pathology*
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam; D015742:Propofol