title: Postmortem Concentration and Redistribution of Diazepam, Methadone, and Morphine with Subclavian and Femoral Vein Dissection/Clamping.
abstract: Postmortem redistribution (PMR) concerns blood drug concentration variations after death, depending on many factors such as sampling site and technique. In our study, we focused on sampling method. 30 cases were sampled, each at cardiac, subclavian, femoral, and popliteal sites. Targeted substances were diazepam, methadone, and morphine. Blind stick and dissection/clamping techniques were concomitantly performed at subclavian and femoral sites. Subclavian and femoral concentrations were compared according to technique used. To assess the influence of sampling technique on PMR, central/peripheral ratios were calculated depending on sampling method. Results show that drug concentrations tend to be lower when drawn from a clamped subclavian or femoral vein whereas ratios including subclavian and/or femoral blood concentration are influenced according to the technique used. In conclusion, clamping a subclavian or femoral vessel before sampling tends to result in lower drug concentrations and may influence ratios, suggesting the importance of isolating vessels from thoraco-abdominal viscera.
authors: Department of Forensic Medicine, Medico-legal Institute of the University of Liège, Liège, Belgium.
authors: Eric
authors: E
authors: Lemaire
authors: Department of Pathology, University of Michigan, Ann Arbor, MI.
authors: Carl
authors: C
authors: Schmidt
authors: Medico-legal Toxicology Laboratory, University Hospital - C.H.U. Sart Tilman, Liège, Belgium.
authors: Raphael
authors: R
authors: Denooz
authors: Medico-legal Toxicology Laboratory, University Hospital - C.H.U. Sart Tilman, Liège, Belgium.
authors: Corinne
authors: C
authors: Charlier
authors: Department of Forensic Medicine, Medico-legal Institute of the University of Liège, Liège, Belgium.
authors: Philippe
authors: P
authors: Boxho
mesh_terms: D003250:Constriction; D003975:Diazepam / Q000493:pharmacokinetics*; D005268:Femoral Vein / Q000737:chemistry*; D006801:Humans; D008691:Methadone / Q000493:pharmacokinetics*; D009020:Morphine / Q000493:pharmacokinetics*; D011180:Postmortem Changes
chemical_list: D009020:Morphine; D003975:Diazepam; D008691:Methadone
keywords: blind stick; dissection/clamping; forensic science; forensic toxicology; postmortem redistribution; sampling method; sampling site