Toxic Methemoglobinemia Due to Prilocaine Use

Kızılyıldız, Baran Serdar; Sönmez, Bülent; Karaman, Kamuran; Çaksen, Hüseyîn

doi:10.1016/j.jemermed.2008.02.033

Cited by 7 publications

(11 citation statements)

References 4 publications

(4 reference statements)

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“…Lethargy and stupor, and then dysrhythmias and seizures, usually appear at about 50%, and the lethal concentration is probably greater than 70%. (Kızılyıldız et al, 2008;Osterhoudt et al, 1995). The near-lethal level of methemoglobin observed in our patient may be attributed to age.…”

Section: Discussionmentioning

confidence: 45%

“…MTH is characterized by elevation of haemoglobin levels with oxidized iron to ferric form (Fe 3+ ) which is inadequate for carrying oxygen (Gold and Bithoney, 2003;Kızılyıldız et al, 2008). MTH results most commonly from a toxic exposure.…”

Section: Discussionmentioning

confidence: 99%

“…Although ascorbic acid was used in few cases from the literature as a supplemental treatment for MTH (Dötsch et al, 1998;Linakis et al, 1989;Saladino, 2004), our patient responded dramatically to ascorbic acid infusion alone, despite the high level of methemoglobin. Recently, Kızılyıldız et al (2008) reported a case of toxic MTH in a two months old boy, successfully treated by ascorbic acid alone.…”

Section: Discussionmentioning

confidence: 99%

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Severe toxic methemoglobinemia mimicking septic shock in an infant

Khémiri

Labassi

Tlili

et al. 2009

International Emergency Nursing

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Severe toxic methemoglobinemia mimicking septic shock in an infant

Khémiri

Labassi

Tlili

et al. 2009

International Emergency Nursing

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“…Besides, presence of cyanosis and the cyanosis's not improving with oxygen therapy despite normal PaO 2 concentration in arterial blood gas in methaemoglobinaemia cases is an important finding. In some cases, O 2 saturation may decrease and may show inconsistency with PaO 2 concentration (15). Another diagnostic tool in methaemoglobinaemia is the CO-oximeter.…”

Section: Discussionmentioning

confidence: 99%

The Role of Preoperative Evaluation for Congenital Methemoglobinemia

Kuş¹,

Berk²,

Hoşten³

et al. 2014

Turk J Anesth Reanim

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Preoperative care includes a clinical examination before invasive or non-invasive interventions for anaesthesia/analgesia and is the responsibility of the anaesthesiologists. Methemoglobinemia should be considered, as well as cardiac, pulmonary, and peripheral circulatory disorders in patients with central cyanosis and low oxygen saturation despite treatment with sufficient oxygen during anaesthesia. Methemoglobinemia is a serious clinical condition, associated with increased blood methemoglobin levels characterized by clinical signs, such as cyanosis and hypoxia due to lack of oxygen-carrying capacity. Here, we present our anaesthesia management in a patient with unnoticed congenital methemoglobinemia during preoperative evaluation, in whom clinical signs of methemoglobinemia developed after local anaesthesia administration before the surgery.

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“…N-acetylcysteine and ascorbic acid have been proposed as alternative reductant therapies to methylene blue. Preclinical evidence for the role of ascorbic acid [21] has been validated by its successful use as primary therapy for methemoglobinemia [22,23]. Unlike methylene blue, its antioxidant effect is independent of NADPH [17].…”

Section: Discussionmentioning

confidence: 99%

Rasburicase Causing Severe Oxidative Hemolysis and Methemoglobinemia in a Patient with Previously Unrecognized Glucose-6-Phosphate Dehydrogenase Deficiency

et al. 2013

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Rasburicase is frequently used in tumor lysis syndrome (TLS). Although it is very well tolerated, it can cause severe oxidative hemolytic anemia and methemoglobinemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. We report another case of rasburicase-induced methemoglobinemia in a patient with previously unrecognized G6PD deficiency and review the cases of methemoglobinemia and oxidative hemolysis reported in the literature to date. Patients from ethnicities in which G6PD deficiency is prevalent at high risk of TLS should be screened for G6PD deficiency prior to administration of rasburicase where practical. Asymptomatic decrease in oxygen saturation by oximetry and cyanosis are signs of methemoglobinemia; patients recover with conservative measures including supplemental oxygen and packed red cell transfusion.

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Toxic Methemoglobinemia Due to Prilocaine Use

Cited by 7 publications

References 4 publications

Severe toxic methemoglobinemia mimicking septic shock in an infant

Severe toxic methemoglobinemia mimicking septic shock in an infant

The Role of Preoperative Evaluation for Congenital Methemoglobinemia

Rasburicase Causing Severe Oxidative Hemolysis and Methemoglobinemia in a Patient with Previously Unrecognized Glucose-6-Phosphate Dehydrogenase Deficiency

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