Acquired Methemoglobinemia After Application of Prilocaine

Prilocaine is a local anesthetic agent and is widely used in most of ambulatory procedures, but it can cause methemoglobinemia which is a life-threatening condition. Methemoglobinemia may cause hypoxia of tissue because methemoglobin has less oxygen carrying capability than hemoglobin. A 54-day-old...

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Main Authors: Çapan Konca, Zelal Kahramaner, Mehmet Çoban
Format: Article
Language:English
Published: Galenos Publishing House 2014-04-01
Series:Güncel Pediatri
Subjects:
Online Access:http://dx.doi.org/10.4274/jcp.84803
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author Çapan Konca
Zelal Kahramaner
Mehmet Çoban
author_facet Çapan Konca
Zelal Kahramaner
Mehmet Çoban
author_sort Çapan Konca
collection DOAJ
description Prilocaine is a local anesthetic agent and is widely used in most of ambulatory procedures, but it can cause methemoglobinemia which is a life-threatening condition. Methemoglobinemia may cause hypoxia of tissue because methemoglobin has less oxygen carrying capability than hemoglobin. A 54-day-old boy who developed cyanosis around his mouth, on his hands and toes two hours after the circumcision operation was admitted to the emergency department. No abnormality was established on his physical examination except for cyanosis. Cyanosis did not improve with oxygen administration and the patient was admitted to intensive care unit. His history revealed that prilocaine hydrochloride (2 mg/kg) was administered subcutaneously as local anesthesia prior to circumcision operation. Diagnosis of methemoglobinemia was established in the patient in whom saturation levels were low in spite of the oxygen therapy and in whom methemoglobinemia level was 24.7%. His cyanosis completely disappeared after administration of intravenous ascorbic acid (300 mg/kg/dose) and he was discharged after a 24-hour follow-up period with recovery. Methemoglobinemia should be considered in cases with cyanosis and inconsistency between oxygen saturation and partial arterial oxygen pressure. These cases should be monitored in pediatric intensive care units for lethal complications. (The Jo­ur­nal of Cur­rent Pe­di­at­rics 2014;1:54-7)
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id doaj-art-b883580e8fb54c88892b7b204c8a9aa9
institution Kabale University
issn 1304-9054
language English
publishDate 2014-04-01
publisher Galenos Publishing House
record_format Article
series Güncel Pediatri
spelling doaj-art-b883580e8fb54c88892b7b204c8a9aa92025-01-02T18:25:43ZengGalenos Publishing HouseGüncel Pediatri1304-90542014-04-01121545710.4274/jcp.84803Acquired Methemoglobinemia After Application of PrilocaineÇapan Konca0 Zelal Kahramaner1Mehmet Çoban2Adıyaman Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Yoğun Bakım Ünitesi, Adıyaman, TürkiyeAdıyaman Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Adıyaman, TürkiyeAdıyaman Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Adıyaman, TürkiyePrilocaine is a local anesthetic agent and is widely used in most of ambulatory procedures, but it can cause methemoglobinemia which is a life-threatening condition. Methemoglobinemia may cause hypoxia of tissue because methemoglobin has less oxygen carrying capability than hemoglobin. A 54-day-old boy who developed cyanosis around his mouth, on his hands and toes two hours after the circumcision operation was admitted to the emergency department. No abnormality was established on his physical examination except for cyanosis. Cyanosis did not improve with oxygen administration and the patient was admitted to intensive care unit. His history revealed that prilocaine hydrochloride (2 mg/kg) was administered subcutaneously as local anesthesia prior to circumcision operation. Diagnosis of methemoglobinemia was established in the patient in whom saturation levels were low in spite of the oxygen therapy and in whom methemoglobinemia level was 24.7%. His cyanosis completely disappeared after administration of intravenous ascorbic acid (300 mg/kg/dose) and he was discharged after a 24-hour follow-up period with recovery. Methemoglobinemia should be considered in cases with cyanosis and inconsistency between oxygen saturation and partial arterial oxygen pressure. These cases should be monitored in pediatric intensive care units for lethal complications. (The Jo­ur­nal of Cur­rent Pe­di­at­rics 2014;1:54-7)http://dx.doi.org/10.4274/jcp.84803Childhoodmethemoglobinemiaapplication of prilocain
spellingShingle Çapan Konca
Zelal Kahramaner
Mehmet Çoban
Acquired Methemoglobinemia After Application of Prilocaine
Güncel Pediatri
Childhood
methemoglobinemia
application of prilocain
title Acquired Methemoglobinemia After Application of Prilocaine
title_full Acquired Methemoglobinemia After Application of Prilocaine
title_fullStr Acquired Methemoglobinemia After Application of Prilocaine
title_full_unstemmed Acquired Methemoglobinemia After Application of Prilocaine
title_short Acquired Methemoglobinemia After Application of Prilocaine
title_sort acquired methemoglobinemia after application of prilocaine
topic Childhood
methemoglobinemia
application of prilocain
url http://dx.doi.org/10.4274/jcp.84803
work_keys_str_mv AT capankonca acquiredmethemoglobinemiaafterapplicationofprilocaine
AT zelalkahramaner acquiredmethemoglobinemiaafterapplicationofprilocaine
AT mehmetcoban acquiredmethemoglobinemiaafterapplicationofprilocaine