title: HPLC-DAD determination of mepivacaine in cerebrospinal fluid from a fatal case.
abstract: A fatal case involving mepivacaine-induced epidural anesthesia is described. The pathological findings were typical of cardiac shock from ischemic origin. Cerebrospinal fluid (CSF) was obtained several hours after death and mepivacaine was identified by gas chromatography-mass spectrometry (GC-MS). Its concentration was determined by high performance liquid chromatography with diode array detection (HPLC-DAD). Extraction from CSF was performed by deproteinization with acetonitrile. The mepivacaine concentration in the sample was 264 microg/mL. Concentrations of mepivacaine in CSF following epidural anesthesia are not reported in literature to our knowledge. This is the first reported case of death in which the mepivacaine concentration in CSF has been determined.
authors.affiliation: Dipartimento Farmaco Chimico Tossicologico, Università degli Studi di Sassari, Via Muroni 23/a, 07100 Sassari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Nieddu
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Boatto
authors.forename: Domenico
authors.initials: D
authors.lastname: Serra
authors.forename: Aldo
authors.initials: A
authors.lastname: Soro
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lorenzoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Lubinu
mesh_terms: D000097:Acetonitriles; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000134:cerebrospinal fluid*; D002851:Chromatography, High Pressure Liquid; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000134:cerebrospinal fluid*; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000473:pathology
chemical_list: D000097:Acetonitriles; D000779:Anesthetics, Local; D008619:Mepivacaine; C032159:acetonitrile