Methemoglobinemia caused by benzocaine topical spray.
Acute methemoglobinemia is a medical emergency that can rapidly become fatal. A substantial number of drugs, including topical preparations, can precipitate this condition. I report a rare example of severe, acute methemoglobinemia caused by oropharyngeal anesthesia with topical benzocaine spray for orogastric intubation. The pathophysiology, diagnosis, and treatment of methemoglobinemia are reviewed briefly.
Cooper
H A
HA
Department of Medicine, Duke University Medical Center, Durham, NC, USA.
D000208:Acute Disease; D000287:Administration, Topical; D000328:Adult; D000336:Aerosols; D000772:Anesthesia, Local / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects*; D000931:Antidotes / Q000627:therapeutic use; D001566:Benzocaine / Q000009:adverse effects*; D003490:Cyanosis / Q000139:chemically induced; D004630:Emergencies; D013271:Gastric Dilatation / Q000628:therapy; D006801:Humans; D007441:Intubation, Gastrointestinal; D015470:Leukemia, Myeloid, Acute / Q000150:complications; D008297:Male; D008706:Methemoglobin / Q000032:analysis* / Q000187:drug effects; D008751:Methylene Blue / Q000627:therapeutic use; D009960:Oropharynx / Q000187:drug effects
D000336:Aerosols; D000779:Anesthetics, Local; D000931:Antidotes; D008706:Methemoglobin; D008751:Methylene Blue; D001566:Benzocaine