A suicidal poisoning due to tramadol. A metabolic approach to death investigation

作者：Barbera Nunziata; Fisichella Marco; Bosco Andrea; Indorato Francesca; Spadaro Giorgio; Romano Guido^*

来源：Journal of Forensic and Legal Medicine, 2013, 20(5): 555-558.

DOI：10.1016/j.jflm.2013.03.006

• Tramadol
• Postmortem
• Metabolic ratio
• O-desmethyltramadol
• N-desmethyltramadol

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 %26gt;1) is indicative of acute death, while M1/M2 ratio %26lt;1 suggests that death occurred after a longer time lapse from ingestion.

• 出版日期2013-7