Determination of chronic abuse of the anaesthetic agents midazolam and propofol as demonstrated by hair analysis.
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.
Cirimele
Vincent
V
Institut de Médecine Légale, Strasbourg, France. vincent.cirimele@medecine.u-strasbg.fr
Kintz
Pascal
P
Doray
Stephane
S
Ludes
Bertrand
B
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*
D018686:Anesthetics, Intravenous; D008874:Midazolam; D015742:Propofol