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International Journal of Legal Medicine

, Volume 114, Issue 4–5, pp 248–251 | Cite as

Death after excessive propofol abuse

  • S. Iwersen-Bergmann
  • P. Rösner
  • H. C. Kühnau
  • M. Junge
  • A. Schmoldt
Case report

Abstract

Abuse of the anaesthetic agent propofol (2,6-diisopropylphenol) is rare, but we report a case of a 26-year-old male nurse in which the autopsy showed unspecific signs of intoxication and criminological evidence pointed towards propofol abuse and/or overdose. Intravenously administered propofol is a fast and short-acting narcotic agent, therefore it seemed questionable whether the deceased would have been able to self-administer a lethal overdose before losing consciousness. The blood and brain concentrations corresponded to those found 1–2 min after bolus administration of a narcotic standard dose of 2.5 mg propofol/kg body weight. Extremely high propofol concentrations were found in the urine indicating excessive abuse before death. However, due to the short half-life of propofol, the cumulative effects of repeated injections should not be relevant for toxicity, since this would result in a blood level increase of only 1–2 μg/ml. Furthermore, the detection and quantitation of propofol in three different hair segments indicated chronic propofol abuse by the deceased. The results of the investigation suggest that death was not caused by a propofol overdose but by respiratory depression resulting from overly rapid injection.

Keywords Propofol abuse Fatality Propofol overdose Hair analysis Brain concentration 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • S. Iwersen-Bergmann
    • 1
  • P. Rösner
    • 2
  • H. C. Kühnau
    • 3
  • M. Junge
    • 1
  • A. Schmoldt
    • 1
  1. 1.Department of Legal Medicine, Butenfeld 34, University of Hamburg, 22529 Hamburg
  2. 2.Landeskriminalamt Schleswig-Holstein, Mühlenweg 166, 24116 Kiel, GermanyDE
  3. 3.Department of Anaesthesia, St. Georg Hospital Hamburg, Lohmühlenstrasse 5, 20099 Hamburg, GermanyDE

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