title: Seizures and methemoglobinemia in an infant after excessive EMLA application.
abstract: Topical anesthetics are commonly used in many health care settings and for many clinical conditions. However, there are a number of potential adverse effects associated with their use. Their widespread administration can convey a false sense of security and failure to appreciate possible complications. We present the case of an infant with extensive vascular malformations treated with EMLA cream who developed seizures and methemoglobinemia from lidocaine and prilocaine toxicity. We describe the pathophysiology of these morbidities, the use of pulse oximetry in this setting, and the clinical presentation and treatment of methemoglobinemia.
authors: Department of Pediatrics, University of Colorado Anschutz Medical Center, Children's Hospital Colorado, Aurora, USA. Austin.Larson@Childrenscolorado.org
authors: Austin
authors: A
authors: Larson
authors: Timothy
authors: T
authors: Stidham
authors: Shireen
authors: S
authors: Banerji
authors: Jon
authors: J
authors: Kaufman
mesh_terms: D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D000077442:Lidocaine, Prilocaine Drug Combination; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000628:therapy; D019339:Port-Wine Stain / Q000628:therapy; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects*; D012640:Seizures / Q000139:chemically induced*
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine