umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Fatal bupivacaine overdose through intrathecally positioned epidural catheter
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
2013 (English)In: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 19, no 1, 10-12 p.Article in journal (Refereed) Published
Abstract [en]

We describe a fatality due to an intrathecally positioned epidural catheter and an infusion rate of bupivacaine set 10 times higher than planned. The undetected misplacement, despite safety routines, is discussed along with the toxicological findings and new information on the intrathecal distribution of bupivacaine. From a clinical point of view, the human factor, in combination with an indistinct decimal point on the pump, was considered as the reason for the unfortunate overdose. In continuous epidural infusion of local anesthetics, the importance of guidelines and informed staff in managing complications of epidural lumbar infusion as well as careful monitoring of the vital functions is essential. Guidelines are also vital during the procedure of insertion of epidural catheters. When using combined spinal and epidural anaesthesia, we believe that an epidural catheter should be inserted, and its position tested, prior to spinal anesthesia. The case also illustrates the need of innovative investigation techniques to confirm the suspicion of unusual manifestations of inadvertent drug effects. Segmental analysis, together with analyses in a control case, enabled us to elucidate the high and varying tissue concentrations in the central nervous system.

Place, publisher, year, edition, pages
Walter de Gruyter, 2013. Vol. 19, no 1, 10-12 p.
Keyword [en]
Guidelines, Spinal cord, Toxicology
National Category
Forensic Science
Research subject
Forensic Medicine
Identifiers
URN: urn:nbn:se:umu:diva-97060DOI: 10.2478/sjfs-2013-0003OAI: oai:DiVA.org:umu-97060DiVA: diva2:770249
Available from: 2014-12-10 Created: 2014-12-10 Last updated: 2017-12-05Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Davies Forsman, LinaÖström, MatsSvanström, MikaelEriksson, Anders
By organisation
Forensic MedicineDepartment of Surgical and Perioperative Sciences
In the same journal
Scandinavian Journal of Forensic Science
Forensic Science

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 83 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf