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Investigators are looking at three substances found in the singer\u2019s blood: midazolam, flumazenil and propofol. Experts are examining the order, the doses and the conditions in which Dr Ioanna Gaka, 56, one of two doctors accused in the case, gave them.<\/p>\n
Gaka and her husband, Dr Ilias Theodoropoulos, 58, ran the practice on Karneadou Street, in central Athens, where Mazonakis died. Both are in pre-trial detention and deny wrongdoing.<\/p>\n
Anaesthetist Dimitris Manikis spoke about the drugs in a television interview. He said that midazolam and propofol can both cause apnoea, which means breathing stops, as their main side effect.<\/p>\n
While midazolam has an antidote, there is no propofol antidote, Manikis said. As a result, he said, the only option in a case of apnoea is to support the patient\u2019s breathing at once with specialist equipment.<\/p>\n
Manikis said that when he sees the risk of breathing stopping, he does \u201ctwo things\u201d<\/em>. He gives the antidote, when one exists, and replaces the patient\u2019s breathing.<\/p>\n Without a propofol antidote, he said, that second step depends on the skills of an anaesthetist. \u201cI give you air with positive pressure from outside,\u201d<\/em> he said.<\/p>\n He also said there is no propofol antidote for a drug whose effect lasts five to 10 minutes.<\/p>\n When midazolam and propofol are combined, the effect becomes much stronger, Manikis said. \u201cIt doesn\u2019t just add up, it multiplies,\u201d<\/em> he said.<\/p>\n In that case, he said, apnoea is a given. According to Manikis, giving such drugs outside a hospital, or without an anaesthetist present, is extremely dangerous.<\/p>\n Propofol is an intravenous anaesthetic used for sedation and to start general anaesthesia, according to the US National Library of Medicine\u2019s StatPearls reference<\/a>.<\/p>\n Greek City Times reported on 5 October that toxicology tests had found propofol in the singer\u2019s system. Later, on 9 October, authorities froze the assets of doctors held over his death.<\/p>\n The couple face charges of homicide with possible intent by omission. No court has ruled on the case, and the investigation is continuing.<\/p>\n Source: Ta Nea<\/em><\/p>\n \u00a0<\/p>\n <\/p>\nCombined sedatives<\/h3>\n