Benzocaine-induced methemoglobinemia.
A case is reported in which a patient developed methemoglobinemia-induced cyanosis while under general anesthesia during surgery for multiple fascial space infections. The cause of methemoglobinemia was 20% benzocaine spray used for local anesthesia before intubation. Acutely developing methemoglobinemia is infrequently encountered in clinical practice. When confronted with cyanosis in the absence of cardiac or pulmonary disease, one must seriously consider the diagnosis of methemoglobinemia. The etiology of methemoglobinemia, the causative agents, the diagnosis, and the emergency treatment required are discussed.
Hegedus
Frederick
F
Department of Oral and Maxillofacial Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
Herb
Kathleen
K
D000038:Abscess / Q000601:surgery; D000779:Anesthetics, Local / Q000009:adverse effects*; D001566:Benzocaine / Q000009:adverse effects*; D003490:Cyanosis / Q000139:chemically induced; D004322:Drainage; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008708:Methemoglobinemia / Q000139:chemically induced*; D008751:Methylene Blue / Q000627:therapeutic use; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D000039:Peritonsillar Abscess / Q000601:surgery; D010608:Pharyngeal Diseases / Q000601:surgery
D000779:Anesthetics, Local; D004791:Enzyme Inhibitors; D008751:Methylene Blue; D001566:Benzocaine