Findings of the neuromuscular blocking agent rocuronium in blood from deceased subjects several months after exposure: A report of two cases

Joachim Frost; Per Ole M Gundersen; Wenche Rødseth Brede; Stig Gjerde; Hilde Pleym; Lars Slørdal

doi:10.1016/j.forsciint.2023.111680

Findings of the neuromuscular blocking agent rocuronium in blood from deceased subjects several months after exposure: A report of two cases

Forensic Sci Int. 2023 Jun:347:111680. doi: 10.1016/j.forsciint.2023.111680. Epub 2023 Apr 5.

Authors

Joachim Frost¹, Per Ole M Gundersen², Wenche Rødseth Brede², Stig Gjerde³, Hilde Pleym⁴, Lars Slørdal⁵

Affiliations

¹ Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
² Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway.
³ Department of Intensive Care, Haukeland University Hospital, Bergen, Norway; National Burn Centre, Haukeland University Hospital, Bergen, Norway.
⁴ Clinic of Anesthesia and Intensive Care, St. Olav University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
⁵ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway. Electronic address: [email protected].

PMID: 37062138
DOI: 10.1016/j.forsciint.2023.111680

Abstract

Rocuronium is a neuromuscular blocking agent mainly used in anesthetic procedures. Two patients who died 53 and 76 days, respectively, after their last rocuronium exposure had low (0.002-0.007 mg/L) levels of the drug in femoral blood, urine and vitreous humor samples obtained at autopsy. In neither case, the cause of death was related to the exposure to rocuronium. Here, these two cases are presented and the implications of the findings discussed.

Keywords: Autopsy; Death; Forensic Toxicology; Rocuronium.

Publication types

Case Reports

MeSH terms

Androstanols / adverse effects
Humans
Neuromuscular Blocking Agents*
Neuromuscular Nondepolarizing Agents* / adverse effects
Rocuronium

Substances

Rocuronium
Neuromuscular Nondepolarizing Agents
Androstanols
Neuromuscular Blocking Agents