- The mystery gas used in Moscow during the hostage rescue
likely is not fentanyl, as claimed by Russian health officials, but could
be from a class of anesthetic gases that includes halothane, commonly used
during surgery, experts told United Press International Wednesday.
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- Public Health Minister Yuri Shevchenko was quoted by
Russia's Tass news agency as saying the gas Russian forces used during
the raid Saturday was fentanyl, a type of opiate-based pain killer used
as an anesthetic.
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- Joe Miller, a pharmacologist and professor of cell and
neurobiology at the University of Southern California in Los Angeles, has
looked into the reports coming out of Moscow and told UPI the side effects
and experiences of the survivors do not fit with the known effects of that
drug.
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- "Fentanyl is typically given intravenously"
and not in a gas form, Miller said. The Russians would have had to develop
a method to aerosolize fentanyl and "that's no trivial matter,"
he added.
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- "I never would've guessed they could've gotten an
opiate (such as fentanyl) into an aerosol," said S.J. Enna, professor
of pharmacology at the University of Kansas Medical Center in Kansas City,
Kan. "To my knowledge that has not been done.
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- "Opiates tend to be solids at room temperature,
so you have to modify them so that they can be suspended and sprayed in
a gas," Enna said.
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- Further, naloxone -- a drug used to treat heroin overdoses
-- is a known antidote to fentanyl overdoses and it makes no sense the
Russians did not have this on hand, Miller said.
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- "There was no provision for treating hostages or
anybody else with naloxone. So they're incredibly stupid, which is unlikely,
or the stuff was not fentanyl," he said.
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- Shevchenko said that doctors had been warned before the
attacks that fentanyl was being used and they should use naloxone to treat
survivors. This conflicts with earlier reports that physicians were not
told what the gas was or that naloxone might be an antidote.
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- A more likely candidate is a class of gas called halogenated
anesthetics, Miller said. These are "bluish-gray in color and taste
sweet and they all knock you out in seconds," he said, noting all
these characteristics fit with reports coming from the survivors.
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- Some of the hostage survivors have reported a sweet taste
and Miller said there is no other gas class that has that characteristic.
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- A German toxicologist has reported finding traces of
halothane, a member of the halogenated class, in tissue samples taken from
two Germans exposed to the gas during the raid.
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- Duraiyah Thangathurai, chief of anesthesia and director
of intensive care unit at USC's Norris Comprehensive Cancer Center, agreed
the gas the Russians used probably was not fentanyl and added halothane
was a more plausible candidate.
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- "Fentanyl's primary effect is pain relief, not unconsciousness,
so there's no rational reason" for the Russians to have used it, he
said. "Fentanyl doesn't make people unconscious initially. It stops
breathing first."
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- The symptoms observed in the hostages more closely fit
the halothane class, he said. These drugs are used every day in surgery
in gas form, so there is a lot known about them and their effects on people,
and it would make sense the Russians would use a well-known compound, he
said.
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- More than 100 hostages were killed by the gas and this
could be explained by the use of halothane. "The lethal dose and the
anasthetic dose are fairly close so it would be a dangerous substance used
under these circumstances," Enna said.
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- In addition, if fentanyl was used, then traces of it,
and not halothane, would have been found in the tissue samples analyzed
by the scientist in Germany, Thangathurai said.
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- He said that fentanyl could be aerosolized in minute
amounts but he is "not sure how it can be done in massive amounts"
as was used in the Russian raid.
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- "They may have used some small dose of fentanyl
with a mixture of a hydrocarbon (such as halothane) ... but I don't think
fentanyl alone," he said.
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- Enna agreed it might have been a combination of fentanyl
and halothane.
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- "I find it hard to believe it would be just halothane
... because you'd have to have a pretty good dose to knock people out.
In a room of that size, it would be diffiult" to expose people to
high doses of halothane, he said.
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- "That combination (of halothane and fentanyl) has
been used routinely for surgical procedures," Enna said. But he noted
that even in that situation, fentanyl is given as an injection and not
as a gas, but it does raise the possibility the Russians managed to incorporate
small amounts of fentanyl into the halothane gas.
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- "There's no antidote for (halothane) and that would
explain why the Russians were not ready with an antidote," Miller
said.
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- It would also explain why they did not inform doctors
what the compound was "because it wouldn't have done any good,"
he added.
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- Halogenated anesthetics also would persist in the body
and that fits with reports some of the hostages have not fully recovered
and remain in critical condition, Miller said.
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- "That would be consistent with a heavy dose of halothane,"
he said.
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- There are reports that naloxone appeared to benefit some
of the survivors, and Miller said there is "some possibility that
naloxone might also help some people" exposed to halothane.
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- It is not known how halothane works in the body so naloxone
also may counteract the effect of this drug "but it's not something
you typically give in surgery if you think you've overdosed a patient with
halothane," he said.
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- Enna said a combination gas would also fit with the naloxone
reports. Naloxone would be of some benefit because it would block the effects
of fentanyl although it would probably not block the halothane component
of the gas, he said.
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