Zehra Jaffery1, Karthik Ananthasubramaniam. 1. Department of Internal Medicine, Heart and Vascular Institute, Henry Ford Hospital, 2799 West Grand Boulevard, K-14, Detroit, MI 48202, USA.
Abstract
BACKGROUND: Benzocaine induced methemoglobinemia is an uncommon, potentially fatal condition. CASE REPORT: A 44-year-old woman with a history of hepatitis C and intravenous drug use was referred for transesophageal echocardiography for bacteremia evaluation. During induction of topical anesthesia with benzocaine spray she became cyanotic. Pulse oximetry revealed marked desaturation (75%) but was discordant from arterial blood O(2) saturation (99%). Due to clinical suspicion, methemoglobin level was measured and noted to be 69%. The patient was treated with 2 mg/kg of methylene blue intravenously with resolution of her symptoms. CONCLUSION: Physicians using topical anesthesia in endoscopic suites should be aware of this rare, potentially life-threatening treatable condition. High clinical suspicion and availability of methylene blue in endoscopy suites will facilitate prompt diagnosis and treatment.
BACKGROUND:Benzocaine induced methemoglobinemia is an uncommon, potentially fatal condition. CASE REPORT: A 44-year-old woman with a history of hepatitis C and intravenous drug use was referred for transesophageal echocardiography for bacteremia evaluation. During induction of topical anesthesia with benzocaine spray she became cyanotic. Pulse oximetry revealed marked desaturation (75%) but was discordant from arterial blood O(2) saturation (99%). Due to clinical suspicion, methemoglobin level was measured and noted to be 69%. The patient was treated with 2 mg/kg of methylene blue intravenously with resolution of her symptoms. CONCLUSION: Physicians using topical anesthesia in endoscopic suites should be aware of this rare, potentially life-threatening treatable condition. High clinical suspicion and availability of methylene blue in endoscopy suites will facilitate prompt diagnosis and treatment.
Authors: Elliot V Hersh; Sebastian G Ciancio; Arthur S Kuperstein; Eric T Stoopler; Paul A Moore; Sean G Boynes; Steven C Levine; Paul Casamassimo; Rina Leyva; Tanya Mathew; Othman Shibly; Paul Creighton; Gary E Jeffers; Patricia M A Corby; Stanley N Turetzky; Athena Papas; Jillian Wallen; Cynthia Idzik-Starr; Sharon M Gordon Journal: J Am Dent Assoc Date: 2013-05 Impact factor: 3.634