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发表于 2010-2-19 19:16:29
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本帖最后由 飞扬清婉 于 2010-2-19 19:36 编辑
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Michael Jackson toxicology report released
February 13, 2010, 2:25 pm
This week, the Los Angeles medical examiner’s office released the autopsy report on Michael Jackson. Included in the release are toxicology findings, and a discussion by an anesthesiologist concerning the effects and proper administration of propofol. The cause of death was listed as “acute propofol intoxication”, with the “benzodiazepine effect” contributing. The toxicology tests determined the following:
Propofol: Heart blood – 3.2 mcg/ml; Hospital blood – 4.1 mcg/ml; Femoral blood – 2.6 mcg/ml
Lidocaine: Heart blood - 0.68 mcg/ml; Hospital blood – 0.5 mcg/ml; Femoral blood – 0.34 mcg/ml
Lorazepam: Heart blood – 0.162 mcg/ml
Diazepam and midazolam were present in trivial quantities.
Baselt’s textbook The Disposition of Toxic Drugs and Chemicals in Man (7th edition) mentions that in 5 fatal cases of acute propofol poisoning, postmortem blood propofol levels ranged from 0.5 – 5.3 mcg/ml. Dr. Selma Calmes, the anesthesiology consultant, concluded that “The levels of propofol found on toxicology exam are similar to those found during general anesthesia for major surgery (intra-abdominal) with propofol infusions, after a bolus induction”.
Note that the level of heart blood propofol at autopsy was higher than that found in the femoral blood. This suggests that propofol undergoes the process of postmortem redistribution. In this phenomenon, after death a drug diffuses out of tissues and into the blood pool, producing a result somewhat higher than the actual level at the moment of death. This effect is more marked in blood obtained from central locations (heart, central vessels) compared to blood drawn from peripheral vessels such as the femoral vein. It is interesting to note that in in this case, the propofol level measured on samples of the hospital blood was higher than either postmortem level. This may be because any intravenous fluid administered to Mr. Jackson during resuscitation in the emergency department diluted the concentration of the drug.
Propofol is marketed under the trade name Diprivan (diisopropyl itravenous anesthetic). It is prepared as a white emulsion, leading to its being nicknamed “Milk of Amnesia”. It is very short acting, with an onset of less than one minute and duration of 5-10 minutes. The potential for abuse of proprofol has been appreciated only recently; there are a number of case reports in the literature of medical personnel who died after self-administering the drug. Propofol causes pain on injection and is often given along with lidocaine. The major toxic effect is respiratory depression. |
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发表于 2010-2-18 13:57:28
发表于 2010-2-18 20:58:53
要真是像图上的一样该多好！
