Avaliação da redistribuição postmortem de opiáceos através de determinação em humor vítreo e sangue cardíaco e periférico humanos

Abstract

Evaluation of the opiates postmortem redistribution through analysis in human cardiac and peripheral blood and vitreous humor samples The abuse of psychoactive substances grows every day worldwide in different segments of the society. Significant increases in the number of drug-related deaths have been reported in recent decades. The class of opiates is one of the most prevalent substances in this context. In forensic toxicology, toxicological analyses are performed in postmortem samples to evaluate whether chemical substances were involved in the death. The completion of this analysis and interpretation of results are very complex due to the deterioration suffered by the corpses, and also by the occurrence of the phenomenon called postmortem redistribution, responsible for the transfer of substances along a concentration gradient after death. In general, the transference of the substances occurred from organs such as liver, heart, lungs and gastrointestinal tract to sites of low concentrations, mainly affecting the blood from central sites and adjacent organs. By this reason, the collection of blood from two different sites of the body for comparison is highly recommendable. Despite being considered a non-conventional specimen, vitreous humor can be quite useful, especially in cases where no blood samples are available for collection. This specimen is usually less prone to bacterial decomposition, and it’s also less affected by postmortem redistribution due to its location further away from central sites. Thus, a method to quantify opiates (free and total morphine, codeine and 6monoacetylmorphine) in postmortem blood (cardiac and peripheral) and in vitreous humor samples was developed and validated. The method showed good accuracy, efficiency and sensibility, with limit of quantification of the 10 ng/ml. Seven samples of postmortem cases with opiates involvement were analyzed to verify the correlation in the concentrations of the sites, and possible occurrence of the redistribution phenomenon.