Propofol and propofol glucuronide concentrations in hair following medical propofol administration and in forensic death cases

Maas, Alexandra; Maier, Christoph; Iwersen‐Bergmann, Stefanie; Pilgrim, Jennifer L.; Rago, Matthew Di; Madea, Burkhard; Heß, Cornelius

doi:10.1007/s11419-017-0399-0

Cited by 3 publications

(1 citation statement)

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“…Propofol produces dosedependent cardiovascular and respiratory depression with a profile similar to methohexital (Procaccianti et al 2017). It has been associated with fatal heart failure both in children and in adult patients with head injuries (Maas et al 2018). The propofol infusion syndrome includes myocardial failure, metabolic acidosis, and rhabdomyolysis in children receiving propofol infusions for more than 48 h (Cremer et al 2001).…”

Section: Summary Of the Most Common Potentially Lethal General Anesmentioning

confidence: 99%

Perioperative and anesthetic deaths: toxicological and medico legal aspects

Argo

Zerbo

Lanzarone

et al. 2019

Egypt J Forensic Sci

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Background: Anesthesia has become safer during decades, though there is still a preventable mortality; the complexity of medical and surgical interventions, increasingly older and sicker patients, has created a host of new hazards in anesthesiology. In this paper, some of these perioperative (PO) fatal adverse events are investigated in terms of health responsibility. Selective literature research in several data bases, concerning perioperative and anesthetic deaths and medical responsibility, was performed. Main text: A generally accepted definition of the anesthesia and perioperatory-related death still remains one of the major concerns in forensic pathology, and the terms "operative deaths" and "anesthetic deaths" are usually applied inaccurately within the medico-legal literature. Such events involve comprehensively PO fatalities and allow for subtle separation of natural and unnatural death, at least from the prospective of forensic pathology. Iatrogenic deaths in this field can be separated into some major categories, as attributable to previous patient's unfavorable conditions or depending from surgical procedure per se (such as PO cardiac and cerebrovascular events). In this review, the authors carried out syntheses of specific research areas regarding epidemiology, complications of general and spinal anesthetic, failure in airway management and patient's circulatory homeostasis, and adverse drugs reactions; analysis considering the challenge of anesthetic-related mortality, epidemiology and classifications, by indicating causal chain of death, in respect of both contributing and associated anesthetic and surgery facts. Conclusions: Perioperative quality control programs and its relevance for medico-legal evaluation are emphasized as, although mortality rates have decreased worldwide over the last decades, however, preventable drug-related deaths still happen. Such fatal events have to be considered within the field of forensic pathology experts, with regard of malpractice claims, to implement a strategy for preventing potentially fatal complications.

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Section: Summary Of the Most Common Potentially Lethal General Anesmentioning

confidence: 99%