title: Deaths from paracervical anesthesia used for first-trimester abortion, 1972-1975.
abstract: Since January 1, 1972, five women in the United States are reported to have died from paracervical anesthesia used for first-trimester abortions. This report describes the three most recent deaths. Toxic doses of lidocaine, substantiated by post-mortem blood levels of 5 and 9 mug per milliliter, probably led to two deaths; an intolerance to or inadvertent intravenous administration of mepivacaine probably caused the third. Administration of an appropriate dose of local anesthetic appears to be the single most important factor in preventing catastrophic reactions.
mesh_terms: D000028:Abortion, Induced / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods / Q000401:mortality*; D002584:Cervix Uteri / Q000098:blood supply / Q000294:innervation; D004305:Dose-Response Relationship, Drug; D004342:Drug Hypersensitivity / Q000401:mortality; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D008619:Mepivacaine / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009407:Nerve Block / Q000401:mortality*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D014481:United States
chemical_list: D008012:Lidocaine; D008619:Mepivacaine