title: [Acute cyanosis after transcatheter balloon valvuloplasty: toxic methemoglobinemia due to local prilocaine use].
abstract: Methemoglobinemia is characterized by varying degrees of cyanosis due to increased hemoglobin concentrations containing oxidized iron. Prilocaine is a widely used local anesthetic and can cause methemoglobinemia in infants even in therapeutic doses. We present two female infants (younger than 2 months) who developed severe cyanosis after transcatheter pulmonary balloon valvuloplasty and were diagnosed with toxic methemoglobinemia. Both infants were anesthetized with local prilocaine application before balloon valvuloplasty. Methemoglobin levels of the patients were measured as 49.6% and 37.7%, respectively. Both were successfully treated with intravenous methylene blue and ascorbic acid.
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Medicine Faculty of İstanbul University, İstanbul, Turkey. yakupergul77@hotmail.com
authors.forename: Yakup
authors.initials: Y
authors.lastname: Ergül
authors.forename: Kemal
authors.initials: K
authors.lastname: Nişli
authors.forename: Selma
authors.initials: S
authors.lastname: Kalkandelen
authors.forename: Aygün
authors.initials: A
authors.lastname: Dindar
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects*; D001205:Ascorbic Acid / Q000627:therapeutic use; D002404:Catheterization / Q000009:adverse effects; D003490:Cyanosis / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D008751:Methylene Blue / Q000627:therapeutic use; D011318:Prilocaine / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D011318:Prilocaine; D001205:Ascorbic Acid; D008751:Methylene Blue