Concentrations of monoethylglycinexylidide in body fluids of deceased patients after use of lidocaine for endotracheal intubation.
The objective of this study was to determine whether the postmortem concentrations in body fluids of monoethylglycinexylidide (MEGX), a major active metabolite of lidocaine, reflect the circulatory state during cardiopulmonary resuscitation following endotracheal intubation using lidocaine. The concentrations of lidocaine and MEGX in blood, pericardial fluid, bile and/or urine were measured for sixteen patients who had received endotracheal intubation using Xylocaine jelly, a 2% w/v lidocaine hydrochloride preparation. Lidocaine was detected in all of the sixteen cases. Of six patients who had survived 3 h to 10 d following endotracheal intubation, four were MEGX-positive and two were negative. No MEGX was detected in the other ten patients whose hearts had not resumed beating despite attempts at cardiopulmonary resuscitation. MEGX can be an indicator of the vital state of a patient during cardiopulmonary resuscitation; it shows the antemortem use of lidocaine under normal hepatic conditions.
Moriya
F
F
Department of Legal Medicine, Kochi Medical School, Kochi 783-8505, Japan.
Hashimoto
Y
Y