Document Detail

Methemoglobinemia due to application of prilocaine during circumcision and the effect of ascorbic acid.
MedLine Citation:
PMID:  19013416     Owner:  NLM     Status:  MEDLINE    
Local anesthesia with prilocaine has become a routine part of ambulatory circumcision procedures. Methemoglobinemia is a rare but potentially lethal complication of local anesthetics. We report the case of a 42-day-old boy who presented with cyanosis after receiving local anesthesia with prilocaine. Methemoglobin level revealed severe methemoglobinemia (methemoglobin=44.5%). His cyanosis promptly resolved after intravenous administration of ascorbic acid. Cases of local anesthetic-induced methemoglobinemia in urology are under recognized. Although the association between prilocaine use and methemoglobinemia has generally restricted prilocaine use in infants, it is still widely used in ambulatory procedures, especially during circumcision in the neonatal period. Prilocaine should not be used in infants less than 3 months of age because of the risk of methemoglobinemia and alternative local analgesics should be considered among this age group. We also discuss the use of ascorbic acid during treatment in light of the literature.
Perran Boran; Gulnur Tokuc; Zeliha Yegin
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-06-10
Journal Detail:
Title:  Journal of pediatric urology     Volume:  4     ISSN:  1873-4898     ISO Abbreviation:  -     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-17     Completed Date:  2009-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101233150     Medline TA:  J Pediatr Urol     Country:  England    
Other Details:
Languages:  eng     Pagination:  475-6     Citation Subset:  IM    
Dr. Lutfi Kirdar Kartal Research and Training Hospital, 2nd Clinic of Pediatrics, Istanbul, Turkey.
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MeSH Terms
Anesthetics, Local / adverse effects*
Antioxidants / administration & dosage*
Ascorbic Acid / administration & dosage*
Circumcision, Male*
Injections, Intravenous
Methemoglobinemia / chemically induced*,  drug therapy*,  metabolism
Prilocaine / adverse effects*
Reg. No./Substance:
0/Anesthetics, Local; 0/Antioxidants; 50-81-7/Ascorbic Acid; 721-50-6/Prilocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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