Benzocaine administration to facilitate upper endoscopic procedures can result in the relatively uncommon but potentially fatal complication known as methemoglobinemia. For this reason, the Veterans Health Administration (VA) announced on February 8, 2006, that they would stop using benzocaine-containing sprays for procedures involving the mouth and throat. Methemoglobinemia should be considered in any patient who demonstrates cyanosis, respiratory distress, headache, lightheadedness, and a dark, chocolate-colored blood after receiving pharyngeal anesthesia. Prompt recognition of this rare (but potentially fatal) condition is important. Once identified, treatment is generally rapid with methylene blue. The patient should be monitored in the intensive care setting for recurrence. Knowledge of this adverse medication reaction is essential for all gastroenterology nurses.
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Occult Methemoglobinemia in a Medically-Complex 7-Year-Old Child and the Opportunity for Pharmacist Intervention in Pediatric Emergency Medicine.
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Methemoglobinemia is a rare, yet life-threatening disorder that occurs due to an accumulation of methemoglobin in the blood. The clinical presentation often includes dyspnea, cyanosis, and hypoxemia that shows little improvement with the administration of supplemental oxygen. The US Food and Drug Administration (FDA) warns against the administration of benzocaine to those younger than 2 years of age and urges manufacturers to add a statement regarding the possible development of methemoglobinemia to the packaging of any products containing this ingredient.
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Article Synopsis
- * A case involving a 61-year-old woman who experienced respiratory failure after surgery highlighted how benzocaine spray for throat pain may have triggered her methemoglobinemia, worsening her pneumonia symptoms.
- * The patient was successfully treated with high doses of vitamin C and methylene blue, prompting this report to stress the importance of quick diagnosis and treatment for better recovery outcomes.
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