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.

Chemiluminescence Determination of Local Anaesthetic Mepivacaine in Human Plasma and Pharmaceuticals

“…The method is based on the fact that the weak CL signal of Ru(phen) 3 2+ and Ce(IV) is significantly enhanced in the presence of mepivacaine (Scheme 1).…”

“…17 Chemiluminescence (CL) methods thanks to their intrinsic advantages in terms of high sensitivity, wide linear dynamic range, and simple instrumentation have become an important and valuable detection method in analytical chemistry. After the observations reported by Hercules and Lytle (1966), 18 CL reactions with ruthenium(II) complexes such as tris(2,2-bipyridyl)-ruthenium(II), Ru(bpy) 3 2+ , and tris(1,10-phenanthroline)-ruthenium(II), Ru(phen) 3 2+ have been extensively studied and exploited in a wide range of analytical applications. [19][20][21][22][23] The Ru(phen) 3 2+ has been reported to produce more intense CL and electrochemiluminescence (ECL) in aqueous solutions in comparison with Ru(bpy) 3 2+ .…”

“…After the observations reported by Hercules and Lytle (1966), 18 CL reactions with ruthenium(II) complexes such as tris(2,2-bipyridyl)-ruthenium(II), Ru(bpy) 3 2+ , and tris(1,10-phenanthroline)-ruthenium(II), Ru(phen) 3 2+ have been extensively studied and exploited in a wide range of analytical applications. [19][20][21][22][23] The Ru(phen) 3 2+ has been reported to produce more intense CL and electrochemiluminescence (ECL) in aqueous solutions in comparison with Ru(bpy) 3 2+ . [24][25][26][27] Most of the separation methods such as GC and HPLC have higher sensitivity than the proposed CL met- hod in the determination of mepivacaine but some of them have a narrower linear dynamic range 7,8,10,11,13,15 and increased complexity.…”

“…Therapeutic concentrations of mepivacaine in plasma are usually in the range of 2-5 μg mL -1 . 3 It is toxic from 5 to 10 μg mL -1 and its fatal concentration is above 50 μg mL -1 . 4 Therefore, it is important to develop simple and sensitive methods for the determination of this drug.…”

“…Most of the proposed analytical methods for determination of mepivacaine are based on separation techniques such as liquid chromatography, 3,5-9 gas chromatography [10][11][12][13][14] and electrophoresis. [15][16] Furthermore, an electrochemical method has been proposed for determination of mepivacaine.…”