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Local anesthetic mortality: report of case
E V Hersh1, M L Helpin, O B Evans
1University of Pennsylvania, School of Dental Medicine, Philadelphia 19104-6003.
ASDC Journal of Dentistry for Children
|November 1, 1991
Summary
A five-year-old child experienced fatal complications, including seizures and pneumonia, due to a mepivacaine overdose during dental surgery. This case highlights critical medication dosage errors in pediatric anesthesia.
Area of Science:
- Pediatric Anesthesiology
- Dental Pharmacology
- Patient Safety
Background:
- Routine dental procedures in children require precise medication dosing.
- Mepivacaine is a commonly used local anesthetic in pediatric dentistry.
Observation:
- A healthy five-year-old female patient underwent multiple dental extractions.
- The patient received 270 mg of mepivacaine, significantly exceeding the calculated dose of 72 mg.
Findings:
- The mepivacaine overdose led to severe adverse events, including generalized seizures.
- Complications progressed to cardiopulmonary arrest, anoxic brain injury, pneumonia, and ultimately, death.
Implications:
- This case underscores the critical importance of accurate drug calculation and verification in pediatric anesthesia.
- Highlights the potential for fatal outcomes from medication errors in dental settings.
- Emphasizes the need for enhanced vigilance and standardized protocols to prevent anesthetic overdoses in children.