title: A Case Report of Prilocaine-Induced Methemoglobinemia after Liposuction Procedure.
abstract: Prilocaine-induced methemoglobinemia is a rarely seen condition. In this paper, a case is presented with methemoglobinemia developed secondary to prilocaine use in a liposuction procedure, and the importance of this rarely seen condition is emphasized. A 20-year-old female patient presented with complaints of prostration, lassitude, shivering, shortness of breath, and cyanosis. It was learned that the patient underwent nearly 1000 mg prilocaine infiltration 8 hours priorly during a liposuction procedure. At admission, her blood pressure (130/80 mmHg), pulse rate (140 bpm), body temperature (36°C), and respiratory rate (40/min) were recorded. The patient had marked acrocyanosis. The arterial blood gas methemoglobin level was measured as 40%. The patient received oxygen therapy with a mask and was administered vitamin C in normal saline (500 mg tid), N-acetylcysteine (300 mg tid), and 50 mg 10% methylene blue in the intensive care unit of the internal medicine department. Methemoglobin level dropped down to 2% after her treatment with methylene blue and she was clinically cured and discharged 2 days later. Emergency service physicians should remember to consider methemoglobinemia when making a differential diagnosis between dyspnea and cyanosis developing after prilocaine infiltration performed for liposuctions in the adult age group.
authors.affiliation: Department of Emergency Medicine, Muğla Sıtkı Koçman University Medical Faculty, Orhaniye Mahallesi Haluk Ozsoy Caddesi, 48000 Mugla, Turkey.
authors.forename: Birdal
authors.initials: B
authors.lastname: Yildirim
authors.affiliation: Emergency Clinic, Muğla Sıtkı Koçman University Training and Investigation Hospital, Orhaniye Mahallesi Haluk Ozsoy Caddesi, 48000 Mugla, Turkey.
authors.forename: Ulku
authors.initials: U
authors.lastname: Karagoz
authors.affiliation: Department of Emergency Medicine, Muğla Sıtkı Koçman University Medical Faculty, Orhaniye Mahallesi Haluk Ozsoy Caddesi, 48000 Mugla, Turkey.
authors.forename: Ethem
authors.initials: E
authors.lastname: Acar
authors.affiliation: Department of Emergency Medicine, Muğla Sıtkı Koçman University Medical Faculty, Orhaniye Mahallesi Haluk Ozsoy Caddesi, 48000 Mugla, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Beydilli
authors.affiliation: Department of Family Medicine, Muğla Sıtkı Koçman University Medical Faculty, Orhaniye Mahallesi Haluk Ozsoy Caddesi, 48000 Mugla, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Nese Yeniceri
authors.affiliation: Department of Internal Medicine and Medical Oncology, Muğla Sıtkı Koçman University Medical Faculty, Orhaniye Mahallesi Haluk Ozsoy Caddesi, 48000 Mugla, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Tanriverdi
authors.affiliation: Emergency Clinic, Muğla Sıtkı Koçman University Training and Investigation Hospital, Orhaniye Mahallesi Haluk Ozsoy Caddesi, 48000 Mugla, Turkey.
authors.forename: Omer Dogan
authors.initials: OD
authors.lastname: Alatas
authors.affiliation: Clinic of Plastic and Reconstructive Surgery, Muğla Sıtkı Koçman University Training and Investigation Hospital, Orhaniye Mahallesi Haluk Ozsoy Caddesi, 48000 Mugla, Turkey.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Kasap