He injected lidocane/dip through the short as apart of the bolus to induce before starting the drip of diprivan?and when he found mj he used the same syringe to five flumez as did to give the induction dose of lidocaine/dip.would u need to keep giving lidocane once the person is asleep?
This is what I thought too. If he was infusing the propofol from the bottle there would have been no need for the lidocaine once the induction bolus was in and there would have been no lidocaine remaining in the tubing once the propofol drip was underway...just plain propofol.
Then there were at least 2 prepared syringes...why the need for two syringes of propofol and lidocaine?
There was an empty flumaz. vial at the scene. It should have been a 5 ml vial or 0.5mg. If he drew up the whole vial to give and used
one of the syringes to give the flumazenil, but I can't find anywhere how much fluid was in either of the syringes. If he gave the whole 5 ml of flumaz, then how much prop/lido was already in the syringe when he added the flumaz? Maximum of 5 ml (2.5 prop 2.5 Lidocaine) Wouldn't that give murray his 25 mg of propofol (or is my math really really bad tonight) Did he intentionally mix the three so that the flumaz would reverse the benzos as he gave the propofol? What would happen to a person receiving this 'cocktail'? A bad reaction? Or did he just panic and grab any available syringe.
I wish there were a way to know how much prop, lido and flum individually were present in that syringe. Likewise how much was in the other prop/lido syringe. But all I can find is grams which mean nothing to me.
They also recovered 5 ml flumazenil vials (4 of them) but don't list if they were opened.
Yes, this must mean he used the same syringe. With the rest ... can you give me links where you got this from? I wish I'd remember all those details, but it's almost impossible to remember all that.
I agree, elusive.
Coroners report. [
http://dearconradmurray.com/wp-content/uploads/2010/02/Page49-Toxicology-Report-Summary.jpg
A little more on Flumazenil here, this is talking about it's use in benzo overdose but if murray thought michael had received too much, that would qualify as an overdose...
Flumazenil (Anexate) is a competitive benzodiazepine receptor antagonist that can be used as an antidote for benzodiazepine overdose. Its use, however, is controversial as it has numerous contraindications.[3][44] It is contraindicated in patients who are on long-term benzodiazepines...[45] Due to these contraindications and the possibility of it causing severe adverse effects including seizures, adverse cardiac effects, and death,[46][47] in the majority of cases there is no indication for the use of flumazenil in the management of benzodiazepine overdose as the risks in general outweigh any potential benefit of administration.[3][4 In addition, if full airway protection has been achieved, a good outcome is expected, and therefore flumazenil administration is unlikely to be required.[48]
Flumazenil is very effective at reversing the CNS depression associated with benzodiazepines but is less effective at reversing respiratory depression.[44] ... Due to its short half life, the duration of action of flumazenil is usually less than 1 hour, and multiple doses may be needed.[44] When flumazenil is indicated the risks can be reduced or avoided by slow dose titration of flumazenil.[50] Due to risks and its many contraindications, flumazenil should be administered only after discussion with a medical toxicologist.[49][51]
http://en.wikipedia.org/wiki/Benzodiazepine_overdose#Flumazenil