Tramadol distribution in four postmortem cases

Four postmortem cases are reported in which the analgesic drug tramadol was identified. Tramadol is an alkaline extractable drug and elutes from a HP-5 column without the need for derivatization. Two metabolites of tramadol, N-desmethyl and O-desmethyl tramadol were also identified. Heart blood concentrations of tramadol in the four cases ranged from 0.17 to 4.4 mg/l. Tissue distribution of tramadol in the four cases failed to identify a sequestration site. None of the deaths reported were attributed to tramadol intoxication.