Topical anesthetics, such as benzocaine, have been reported to cause methemoglobinemia, in which hemoglobin is unable to release oxygen effectively to body tissues. The pathophysiology, symptoms, and treatment of a 46-year-old patient are examined.
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J Pediatr Pharmacol Ther
December 2024
Pharmacy Services, Hasbro Children's Hospital, Lifespan (KLW, CRS, PHL), Providence, RI.
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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August 2024
Infectious Diseases, University of Alabama at Birmingham, Birmingham, USA.
BMJ Case Rep
February 2022
Pediatrics, Albany Medical Center, Albany, New York, USA
Methaemoglobinaemia is a potentially life-threatening condition characterised by hypoxaemia, cyanosis, pallor, fatigue, metabolic acidosis, headache and in severe cases, coma or death. Topical anaesthetics have been reported to cause methaemoglobinaemia. Topical benzocaine was specifically implicated in roughly 66% of anesthetic-induced methaemoglobinaemia cases in a large systematic review in adults.
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November 2021
Research, St. Joseph Mercy Oakland Hospital, Pontiac, USA.
Methemoglobinemia is a severely dangerous condition that can be induced by congenital mutations or can be acquired. One of the ways to acquire methemoglobinemia is by using topical anesthetics during procedures, such as nasogastric (NG) tube placement, transesophageal echocardiogram (TEE), esophagogastroduodenoscopies (EGD), and during endoscopic retrograde cholangiopancreatography (ERCP). Herein, we present the case of a 35-year-old lady who presented to the hospital for an initial hysterectomy.
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February 2019
Department of Surgery, Harlem Hospital Center, Columbia University Medical Center, New York, NY, USA.
Methemoglobinemia is a rare complication in clinical practice. It is most commonly seen in patients undergoing endoscopic procedures, including EGDs, laryngoscopies, bronchoscopies, and nasogastric tube insertions. This is thought to be a disease seen almost exclusively in patients with genetic predispositions to develop it; the increasing use of topical anesthetics during procedures has made methemoglobinemia a disease entity that every clinical provider should be able to recognize and treat.
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