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Benzocaine‐Induced Methemoglobinemia During an Outpatient Procedure
Author(s) -
Wurdeman Richard L.,
Mohiuddin Syed M.,
Holmberg M. Jeff,
Shalaby Alaa
Publication year - 2000
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.20.7.735.35175
Subject(s) - methemoglobinemia , pulse oximetry , benzocaine , medicine , methemoglobin , anesthesia , outpatient clinic , oxygen saturation , intensive care unit , hemoglobin , intensive care medicine , oxygen , chemistry , organic chemistry
Outpatient transesophageal echocardiography was performed in a 69‐year‐old man with a history of aortic valve repair. During the procedure the patient became markedly cyanotic and hypotensive. Oxygen saturation measured by pulse oximetry decreased from 97% to the mid‐80s. The man's condition continued to deteriorate. On transfer to a critical care unit, blood analysis by co‐oximetry showed methemoglobin saturation of 67.8%. The patient's condition improved significantly after intravenous administration of methylene blue 1 mg/kg. With increasing numbers of outpatient procedures performed under topical anesthesia, measures should be in place to deal with a potential life‐threatening adverse event such as methemoglobinemia.