Fetal Mepivacaine Toxicity Not Established

Abstract

To the Editor: A recent report in the Journal describes perinatal deaths associated with mepivacaine paracervical-block anesthesia in labor.¹ From the evidence presented it is difficult to see how the two infants could have died as a result of the toxic effects of the local anesthetic agent. Even when a large dose of mepivacaine has been accidentally injected into the human fetus, death in utero has not followed.^{2 , 3} In the present cases it is unlikely that the fetuses received the drug directly since maternal pain was adequately relieved. It is also unlikely that the drug was injected intravenously since neither . . .