title: Methemoglobinemia: early intraoperative detection by clinical observation.
abstract: Head and neck surgery patients often receive topical anesthetics in the office for examination or in the operating room for nasotracheal intubation. Benzocaine (a component of many topical preparations) is frequently employed for this purpose. Acute methemoglobinemia is a rare but potentially lethal complication of benzocaine administration. Early recognition and treatment may prevent complications or death. We report a case of acute intraoperative methemoglobinemia, caused by benzocaine spray, which was diagnosed (and reversed) quickly after the clinical observation of "chocolate brown blood" in the surgical field.
authors.affiliation: Section of Head and Neck Surgery, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA. L_Henry@fccc.edu
authors.forename: Leonard R
authors.initials: LR
authors.lastname: Henry
authors.forename: Mark
authors.initials: M
authors.lastname: Pizzini
authors.forename: Bruce
authors.initials: B
authors.lastname: Delarso
authors.forename: John A
authors.initials: JA
authors.lastname: Ridge
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000009:adverse effects*; D001566:Benzocaine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced* / Q000175:diagnosis; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000175:diagnosis; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D001566:Benzocaine