Document Detail

A rare side effect of transesophageal echocardiography: methemoglobinemia from topical benzocaine anesthesia.
MedLine Citation:
PMID:  17074536     Owner:  NLM     Status:  MEDLINE    
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.
Zehra Jaffery; Karthik Ananthasubramaniam
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  9     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-05-20     Completed Date:  2008-08-12     Revised Date:  2008-08-14    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  289-90     Citation Subset:  IM    
Department of Internal Medicine, Heart and Vascular Institute, Henry Ford Hospital, 2799 West Grand Boulevard, K-14, Detroit, MI 48202, USA.
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MeSH Terms
Anesthetics, Local / adverse effects*
Benzocaine / adverse effects*
Echocardiography, Transesophageal*
Enzyme Inhibitors / therapeutic use
Fasciitis, Necrotizing / diagnosis,  microbiology
Methemoglobinemia / chemically induced*,  drug therapy
Methylene Blue / therapeutic use
Staphylococcal Infections / diagnosis
Reg. No./Substance:
0/Anesthetics, Local; 0/Enzyme Inhibitors; 61-73-4/Methylene Blue; 94-09-7/Benzocaine

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

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