Suicide with atracurium in Iran

Atracurium is a nondepolarizing skeletal muscle relaxant used to facilitate endotracheal intubation and to induce skeletal muscle relaxation during surgery or mechanical ventilation. The drug undergoes a spontaneous non-enzymatic biotransformation, yielding laudanosine and an acrylate moiety.In the report, a young woman, a former hospital anesthesia technician and housed in a girls dormitory, was found dead in her dormitory while there was an empty atracurium vial above her head. Blood samples, gastric contents, gallbladder contents, liver tissue were sent to the forensic toxicology laboratory. Samples were extracted simultaneously by SPE and LLE methods. The results of the two extraction methods did not have a significant effect on the results obtained from the injection of samples nto the GC-MS. Acetaminophen was found in the blood samples obtained by GC-MS method. Liver tissue samples were confirmed by GC-MS assay of acetaminophen, codeine, ladanosine (atracuriummetabolite) and alprazolam. Gastrointestinal and gallbladder contents were also detected by GC-MS acetaminophen, codeine and alprazolam. Interestingly, atracurium was not found in any of the samples in this case, but the metabolite of atracurium or ladonosine was found in liver tissue samples, indicating atracurium use, which is consistent with evidence of deceased scene and presence of a deceased bedclothium that the findings of MS. Maria Martinez in 2006 has proven suicide by anesthesia specialist with Atracurium.

کلیدواژه ها:

Suicide ، Atracurium ، Laudanosine ، GC-MS