Mannocchi Giulio, Napoleoni Francesca, Napoletano Simona, Pantano Flaminia, Santoni Mariangela, Tittarelli Roberta, Arbarello Paolo
Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Viale Regina Elena, 336-00161 Rome, Italy.
J Forensic Leg Med. 2013 Aug;20(6):715-9. doi: 10.1016/j.jflm.2013.04.003. Epub 2013 May 20.
We describe a case of unintentional intoxication due to tramadol and propofol self administration, occurred in a middle aged man, healthcare provider, deceased despite advanced medical assistance an hour later the onset of severe and increasing dyspnea. Toxicological analysis performed with gas chromatography-mass spectrometry in blood sample, evidenced a lethal tramadol concentration and therapeutic level of Propofol. Quantitative determination was also performed in other specimens such as bile, tissues (liver, spleen, kidney) and pubic hair, to assess chronic exposure. Toxicological results and autopsy findings, supported by clinical and hematochemical data, suggested a myocardial damage, associated with respiratory failure.
我们描述了一例因自行服用曲马多和丙泊酚导致的意外中毒病例，患者为一名中年男性，是医疗保健人员，在出现严重且逐渐加重的呼吸困难一小时后，尽管接受了高级医疗救助仍不幸死亡。对血液样本进行气相色谱 - 质谱联用的毒理学分析，证实曲马多浓度达到致死水平，丙泊酚处于治疗水平。还对胆汁、组织（肝脏、脾脏、肾脏）和阴毛等其他样本进行了定量测定，以评估长期接触情况。毒理学结果和尸检发现，在临床和血液生化数据的支持下，提示存在与呼吸衰竭相关的心肌损伤。
