Oertel Reinhard, Arenz Norman, Zeitz Sten Gunnar, Pietsch Jörg
Institute of Clinical Pharmacology, TU Dresden, Dresden, Germany.
Institute of Legal Medicine, TU Dresden, Dresden, Germany.
Biomed Chromatogr. 2015 Aug;29(8):1290-6. doi: 10.1002/bmc.3419. Epub 2015 Jan 26.
With screening methods in the legal medicine drugs were often detected in autopsy material. In this study the antiarrhythmic and the local anesthetic drug lidocaine could be proved in fifty-one cases and determined in different autopsy materials. For the first time the comparison of so many distribution patterns of lidocaine in human compartments was possible. A liquid-liquid extraction procedure, a standard addition method and LC/MS/MS were used for analytics. The measured concentrations in blood were in the therapeutic range or lower. The time between lidocaine application and death was given in twenty-nine cases. These data were very helpful to estimate and interpret the distribution process of lidocaine between application and death. This time exerted a crucial influence on the distribution of lidocaine in the compartments. Most of the intravenous applicated lidocaine was found in heart blood after a very short time of distribution. Afterwards the highest concentrations were measured in brain. Later the highest concentration was found in the kidney samples or in urine. If the time between lidocaine application and death is known, the results of this study can be used to deepen the knowledge of its pharmacokinetics. If this time is unknown, the circumstances and the causes of death can be better explained.
在法医学中，通过筛查方法经常能在尸检材料中检测到药物。在本研究中，抗心律失常及局部麻醉药利多卡因在51例尸检材料中得到证实，并在不同的尸检材料中进行了测定。首次实现了对利多卡因在人体各部位如此多分布模式的比较。采用液-液萃取法、标准加入法和液相色谱-串联质谱法进行分析。测得的血液浓度处于治疗范围内或更低。29例给出了利多卡因用药至死亡的时间。这些数据对于估计和解释利多卡因在用药至死亡期间的分布过程非常有帮助。这段时间对利多卡因在各部位的分布产生了关键影响。静脉注射的利多卡因在分布很短时间后大多在心血中被发现。之后在脑中测得最高浓度。随后在肾脏样本或尿液中发现最高浓度。如果知道利多卡因用药至死亡的时间，本研究结果可用于深化对其药代动力学的认识。如果这个时间未知，则可以更好地解释死亡的情况和原因。
