title: Severe methemoglobinemia after dental anesthesia: a warning about propitocaine-induced methemoglobinemia in neonates.
abstract: 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.
authors: 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
authors: Yukari
authors: Y
authors: Doko
authors: Hiroshi
authors: H
authors: Iranami
authors: Keisuke
authors: K
authors: Fujii
authors: Akinori
authors: A
authors: Yamazaki
authors: Manabu
authors: M
authors: Shimogai
authors: Yoshio
authors: Y
authors: Hatano
mesh_terms: 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
chemical_list: D000779:Anesthetics, Local; D011318:Prilocaine