LC-MS/MS analysis of propofol in postmortem blood: propofol glucuronide as an indicator of exposure.

Propofol (PRF) is a short-acting intravenous anesthetic widely used for the induction and maintenance of general anesthesia. However, multiple accidental deaths resulting from the non-therapeutic use of PRF have been reported; therefore, PRF is an important target analyte in forensic investigations. In this study, quantitative analytical methods for PRF and propofol glucuronide (PRG) in postmortem blood were developed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). For quantification, PRF was derivatized with N-(2-(bromomethyl)benzyl)-N,N-diethylethanaminium bromide (CAXB) to increase LC-MS/MS detection sensitivity. PRF was quantified using selected reaction monitoring (SRM) in positive ion mode. The extract was diluted after the derivatization reaction, and the quantification range was set to 0.1-20 μg/mL, which is suitable for routine quantitative analysis of PRF in postmortem blood samples. PRG was quantified using SRM in positive ion mode. Both analytical methods were validated and applied to authentic postmortem blood samples. The utility of PRG as a complementary marker in SRM-based drug screening was evaluated. Our findings demonstrate that PRG is a valuable indicator of PRF exposure in forensic casework and may help address limitations in the routine detection of PRF.