The distribution of laudanosine in tissues after death from atracurium injection

A case is presented involving an acute fatality resulting from self-adminis tration of atracurium, a muscle relaxant by a 45-year-old nurse. In the bod y, atracurium undergoes a spontaneous non-enzymatic degradation to laudanos ine and an acrylate moiety. Laudanosine was quantified using gas chromatogr aphy coupled to mass spectrometry after extraction with chloroform-isopropa nol-n-heptane (50:17:33 v/v) at pH 9.5 and separation on a HPS-MS capillary column. Laudanosine was subject to postmortem redistribution due to releas e from drug-rich tissues such as the lung and heart. The heart blood (917 n g/ml) to peripheral blood (390 ng/ml) ratio was 2.4, No other drugs, includ ing ethanol were detected.