Severe methemoglobinemia on reexposure to benzocaine

Udeh, Chiedozie; Bittikofer, John A.; Sum-Ping, Sam T.

doi:10.1016/s0952-8180(01)00222-7

Cited by 37 publications

(20 citation statements)

References 10 publications

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“…[13,14] When the MetHb level is more than 60%, likelihood of mortality increases; in more than 70% cases, it is lethal. [15] Notably, there is no relationship between symptoms and the level of MetHb. [16] According to our study, there is increase in blood MetHb levels after minor surgical procedures rather than before; however, there are no significant clinical changes and lidocaine does not appear to contribute to the development of methemoglobinemia.…”

Section: Discussionmentioning

confidence: 99%

Methemoglobinemia incidence after the application of lidocaine for small surgical procedures

Günal¹,

Akkuş

Çığşar³

et al. 2017

Agri

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SummaryObjectives: Methemoglobinemia (MetHb) is a rare condition that may have mortal consequences. Literature shows cases of methemoglobinemia due to the use of lidocaine and other local anesthetics. This is a cross-sectional study to determine the incidence of methemoglobinemia after the application of lidocaine. Methods: In this study, 88 patients admitted to the emergency department of a university hospital between May 2014 and May 2015 and needed lidocaine application for small surgical procedures were included. When compared before and after the administration of lidocaine <2 mg/kg and >2 mg/kg, there was not a significant difference in the level of methemoglobin, hemoglobin, or in the hematocrit (p=0.604, p=0.502, and p=0.367, respectively). Results: Mean age of the patients was 33.85 (±17.58) years, and 83% of the patients were male. Methemoglobin levels were not significantly different before and after the procedures (p>0.05). Conclusion:The results of our study were consistent with the literature; lidocaine-associated methemoglobinemia is a rare complication.Keywords: Local lidocaine application; methemoglobinemia; small surgical procedures. ÖzetAmaç: Methemoglobulinemi nadir görülen ancak ölümcül sonuçları olan acil bir durumdur. Literatürde lokal anestezikler ve bunlar içinde yer alan lidokaine bağlı methemoglobinemi oluşumuna ilişkin vakaların olduğu bildirilmiştir. Bu nedenle çalış-mamız lidokain kullanılan hastalarda methemoglobulinemi insidansını belirlemek amacıyla kesitsel olarak yapılmıştır. Gereç ve Yöntem: Bir üniversite hastanesinin acil servisine Mayıs 2014-Mayıs 2015 tarihleri arasında başvuran küçük cerrahi işlem nedeniyle lidokain uygulanması gereken 88 hasta çalışma kapsamına alınmıştır. İşlem öncesi ve sonrası methemoglobulin değerleri ölçülmüştür. Bulgular: Hastaların yaş ortalaması 33.85 (±17.58) olup hastaların %83'ü erkekti. İşlem öncesi ve işlem sonrası karşılaştırıl-dığında lidokainin 2 mg/kg kullanımına göre methemoglobin, hemoglobin ve hemotokrit değerlerinde anlamlı bir farklılık bulunamadı (p=0.604, p=0.502 and p=0.367). Sonuç: Çalışmamızın sonuçları literatürle uyumlu olup lidokaine bağlı methemoglobinemi nadir gelişebilmektedir.Anahtar sözcükler: Lokal lidokain uygulaması; methemoglobinemia; küçük cerrahi işlem.

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Section: Discussionmentioning

confidence: 99%

Methemoglobinemia incidence after the application of lidocaine for small surgical procedures

Günal¹,

Akkuş

Çığşar³

et al. 2017

Agri

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“…The association with benzocaine has been made previously and is probably exacerbated if trauma accelerates the exposure of blood to oxidizing agent, as was the case in the first patient. Almost all of the previous associations have been reported in the cardiology and echocardiography literature [3,4,7,8]. With the increasing frequency of anesthesiologists performing TEE, vigilance about the toxicity of benzocaine is warranted, especially because most of our patients will have some oropharyngeal trauma that will facilitate systemic uptake of drugs.…”

Section: Discussionmentioning

confidence: 99%

“…It is due to oxidation of the iron in hemoglobin from the Fe2+ to the Fe3+ state, rendering the hemoglobin molecule incapable of oxygen carriage [2]. It is usually due to exposure to an oxidizing agent, which can be a challenge to identify [1,[3][4][5][6][7][8]]. …”

Section: Introductionmentioning

confidence: 99%

Methemoglobinemia after transesophageal echocardiography: a life-threatening complication

Jacka

Kruger

Glick

2006

Journal of Clinical Anesthesia

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“…The actual functional level of the enzyme or its efficiency also seems to be important, as most reported cases occur in children and the elderly (13). Physiologic factors such as sepsis, hypoxia, and malnutrition may also predispose to this complication (14). Systemic exposure plays a critical role.…”

Section: ) a Small Amount Of Methemoglobin Is Reduced Viamentioning

confidence: 99%

Severe Methemoglobinemia Linked to Gel-Type Topical Benzocaine Use: A Case Report

Chung¹,

Batra²,

Itzkevitch³

et al. 2010

The Journal of Emergency Medicine

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Severe methemoglobinemia on reexposure to benzocaine

Cited by 37 publications

References 10 publications

Methemoglobinemia incidence after the application of lidocaine for small surgical procedures

Methemoglobinemia incidence after the application of lidocaine for small surgical procedures

Methemoglobinemia after transesophageal echocardiography: a life-threatening complication

Severe Methemoglobinemia Linked to Gel-Type Topical Benzocaine Use: A Case Report

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