title: An Uncommon Complication With Use of Topical Local Anesthetic Agents: Methemoglobinemia.
abstract: Although the use of topical local anesthetics is generally safe, several potentially fatal complications have been reported. Methemoglobinemia is a rare but potentially fatal complication. Methemoglobin is a naturally occurring oxidized metabolite of hemoglobin, and physiologic levels (<1%) are normal. Methemoglobinemia can be congenital or acquired. Several drugs including topical anesthetic agents like benzocaine can induce this condition. Sudden appearance of cyanosis, with a disproportionately better oxygen saturation of 85% after use of local anesthetics can be a helpful for diagnosis.
authors.affiliation: 1Department of Cardiology, Texas Tech University Health Sciences Center, Lubbock, TX; and 2Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
authors.forename: Ragesh
authors.initials: R
authors.lastname: Panikkath
authors.forename: Deepa
authors.initials: D
authors.lastname: Panikkath
authors.forename: Jason
authors.initials: J
authors.lastname: Wischmeyer
mesh_terms: D000287:Administration, Topical; D000779:Anesthetics, Local / Q000009:adverse effects*; D001566:Benzocaine / Q000009:adverse effects*; D003490:Cyanosis / Q000139:chemically induced / Q000628:therapy; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000628:therapy; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D010614:Pharynx
chemical_list: D000779:Anesthetics, Local; D001566:Benzocaine