Methemoglobinemia and benzocaine.
Benzocaine administration to facilitate upper endoscopic procedures can result in the relatively uncommon but potentially fatal complication known as methemoglobinemia. For this reason, the Veterans Health Administration (VA) announced on February 8, 2006, that they would stop using benzocaine-containing sprays for procedures involving the mouth and throat. Methemoglobinemia should be considered in any patient who demonstrates cyanosis, respiratory distress, headache, lightheadedness, and a dark, chocolate-colored blood after receiving pharyngeal anesthesia. Prompt recognition of this rare (but potentially fatal) condition is important. Once identified, treatment is generally rapid with methylene blue. The patient should be monitored in the intensive care setting for recurrence. Knowledge of this adverse medication reaction is essential for all gastroenterology nurses.
Kearney Anesthesia Associates P.C., Bryan/LGH College of Health Sciences, Nurse Anesthesia Program, Kearney, Nebraska 68847, USA. moosd@charter.net
Daniel D
DD
Moos
James D
JD
Cuddeford
D000779:Anesthetics, Local / Q000009:adverse effects*; D001566:Benzocaine / Q000009:adverse effects*; D017277:Drug Approval; D016903:Drug Monitoring; D042241:Early Diagnosis; D016099:Endoscopy, Gastrointestinal / Q000451:nursing; D006801:Humans; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D009730:Nursing Assessment; D017410:Practice Guidelines as Topic; D035583:Rare Diseases; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014486:United States Food and Drug Administration
D000779:Anesthetics, Local; D001566:Benzocaine