Citation

Barbera N, Fisichella M, Bosco A, Indorato F, Spadaro G, Romano G. J. Forensic Leg. Med. 2013; 20(5): 555-558.

Affiliation

Department "G.F. Ingrassia", Laboratory of Forensic Toxicology, University of Catania, Italy.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.jflm.2013.03.006

PMID

23756535

Abstract

Tramadol is a synthetic opioid, widely used for post-surgical and chronic pain. Lethal overdose due only to tramadol is not common; more often the poisoning is due to tramadol in combination with other substances. Reported is a suicidal case of lethal tramadol poisoning in a 48-year-old woman. Tramadol and its metabolites O-desmethyltramadol (M1), N-desmethyltramadol (M2), N,N-didesmethyltramadol (M3), N,O-didesmethyltramadol (M5) were detected by GC/MS in biological fluids (femoral blood, bile, urine, gastric content) and viscera (brain, lung, liver and kidney). The tramadol concentration in femoral blood was 61.83 mcg/ml which is approximately 30 times higher than that believed to be lethal. According with other Authors, a preferential formation of M1 over M2 (M1/M2 ratio >1) is indicative of acute death, while M1/M2 ratio <1 suggests that death occurred after a longer time lapse from ingestion.

Language: en