A fatal accidental subarachnoid injection of lidocaine and levobupivacaine during a lumbar paravertebral block

Highlights • A fatal case involving a 60-year-old woman who underwent paravertebral block. • The physician unintentionally performed a subarachnoid injection (L5-S1bilaterally). • Lidocaine and bupivacaine were detected by GC–MS in blood, CSF and urine. • The cause of death was due to a progressive...

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Veröffentlicht in:	Forensic science international 2015-11, Vol.256, p.17-20
Hauptverfasser:	Busardò, Francesco Paolo, Tritapepe, Luigi, Montana, Angelo, Indorato, Francesca, Zaami, Simona, Romano, Guido
Format:	Artikel
Sprache:	eng
Schlagworte:	Anesthesia Anesthetics, Local - administration & dosage Anesthetics, Local - adverse effects Anesthetics, Local - analysis Autopsies Blocking Bupivacaine Bupivacaine - administration & dosage Bupivacaine - adverse effects Bupivacaine - analogs & derivatives Bupivacaine - analysis Conflicts of interest Death Drugs Fatal Fatal Outcome Female Forensic sciences Forensic toxicology Heart Arrest - chemically induced Humans Injections - adverse effects Lidocaine Lidocaine - administration & dosage Lidocaine - adverse effects Lidocaine - analysis Liquids Local anesthetics Medication Errors Middle Aged Mortality Nerve Block - methods Nerves Neurotoxicity Pain Paravertebral block Pathology Patients Respiratory Insufficiency - chemically induced Subarachnoid Space Urine
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Zusammenfassung:	Highlights • A fatal case involving a 60-year-old woman who underwent paravertebral block. • The physician unintentionally performed a subarachnoid injection (L5-S1bilaterally). • Lidocaine and bupivacaine were detected by GC–MS in blood, CSF and urine. • The cause of death was due to a progressive hypotension and normovolaemic shock.
ISSN:	0379-0738 1872-6283
DOI:	10.1016/j.forsciint.2015.07.017