title: Evaluation and management of acquired methemoglobinemia associated with topical benzocaine use.
abstract: Benzocaine is a widely used topical oropharyngeal anesthetic and has been reported to cause methemoglobinemia. We discuss benzocaine-induced methemoglobinemia and review the causes, presentation, and management of this serious complication. Treatment with methylene blue will result in reversal of methemoglobinemia and clinical recovery in most cases but needs to be used at appropriate doses in carefully selected individuals. Physicians who perform procedures involving the application of benzocaine for topical anesthesia need to rapidly identify and treat methemoglobinemia to avoid significant associated morbidity and mortality.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH, 43614, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Taleb
authors.forename: Zubair
authors.initials: Z
authors.lastname: Ashraf
authors.forename: Shahul
authors.initials: S
authors.lastname: Valavoor
authors.forename: Jodi
authors.initials: J
authors.lastname: Tinkel
mesh_terms: D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D001566:Benzocaine / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D008751:Methylene Blue / Q000008:administration & dosage / Q000627:therapeutic use; D018579:Patient Selection
chemical_list: D000779:Anesthetics, Local; D004791:Enzyme Inhibitors; D008751:Methylene Blue; D001566:Benzocaine