Postmortem Redistribution of Lidocaine after Epidural Anesthesia Accidental DeathZhiwen Wei1, Jie Yu2, Chao Zhang1, Juan Jia1, Jie Cao1, Yujin Wang1, Cairong Gao1, Yingyuan Wang1 and Keming Yun1*
- *Corresponding Author:
- Keming Yun
School of Forensic Medicine, Shanxi Medical University
56 Xinjian South Road, Taiyuan, 030001, People’s Republic of China
E-mail: [email protected]
Received date: November 01, 2017; Accepted date: January 05, 2017; Published date: January 09, 2017
Citation: Wei Z, Yu J, Zhang C, Jia J, Cao J, et al. (2017) Postmortem Redistribution of Lidocaine after Epidural Anesthesia Accidental Death. J Forensic Res 8:363. doi:10.4172/2157-7145.1000363
Copyright: © 2017 Zhiwen W, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Epidural anesthesia is often used form in Chinese primary hospitals and lidocaine is the most favorite anesthetic. Fatalities due to epidural anesthesia accident and lidocaine overdose are often happened, but there still have not obvious evidence to indicate the real reason of death according to the concentration of lidocaine in postmortem blood because the postmortem redistribution (PMR). An animal models using dogs has been developed, whereby the dogs received an intravenous, subarachnoid, and epidural injection of lidocaine (75 mg/kg body weight). The dogs were placed at room temperature after sacrifice. The cardiac blood, inferior vena cava blood, liver and cerebrum samples were collected at 0 h, 1 h, 4 h, 8 h, 24 h, 48 h and 72 h postmortem with the same animal’s corpse. The lidocaine is easier diffusion from canalisvertebralis to cardiac blood in subarachnoid administration. The level commonly has a great change from 48 h after death in cardiac blood, from 35.7 mg/L to 1421.9 mg/L, and then decreasing 50% at 72 h. The inferior vena cava blood concentration was stabilized in postmortem time. The cerebrum concentration of subarachnoid administration decreased by 50% and was observed at 72 h after death. The changes were observed in cardiac blood in intravenous and epidural administration groups, but no changes were observed in cerebrum. Lidocaine concentrations did not change significantly in the liver in any of the three groups. This study can assist toxicologists to determine which specimens should be the most appropriately during the interpretation of lidocaine concentrations in epidural accidents.