Severe methemoglobinemia after dental anesthesia: a warning about propitocaine-induced methemoglobinemia in neonates.
Methemoglobinemia is a fatal complication of local anesthesia. We describe a case report of female neonate who developed severe methemoglobinemia after extraction of neonatal teeth conducted with general anesthesia plus local injection of Citanest-Octapressin(®) (propitocaine of approximately 10 mg/kg). Central cyanosis appeared within an hour after surgery. The percentage of methemoglobin reached up to 43.9%. Not only pediatric dentists but also anesthesiologists generally agree with the idea that local anesthesia provides various benefits in painful procedures in neonates. However, this case may serve as a warning when using Citanest-Octapressin(®), which is still commercially available for neonatal patients.
Doko
Yukari
Y
Department of Anesthesiology, Japanese Red Cross Society Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, Wakayama 640-8558, Japan. yukari_d@khaki.plala.or.jp
Iranami
Hiroshi
H
Fujii
Keisuke
K
Yamazaki
Akinori
A
Shimogai
Manabu
M
Hatano
Yoshio
Y
D000766:Anesthesia, Dental / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008708:Methemoglobinemia / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D011318:Prilocaine / Q000009:adverse effects*; D014081:Tooth Extraction
D000779:Anesthetics, Local; D011318:Prilocaine