Methemoglobinemia Secondary to Topical Benzocaine Application to Gastrostomy Site. Issue 5 (May 2016)

• Record Type: Journal Article
• Authors: Lipton, Matthew; Szlam, Sarah M.; Barker, Kim; Benitez, John G.
• Is Part Of: Pediatric emergency care. Volume 32:Issue 5(2016)
• Publication Date: 2016-05
• Subjects: methemoglobinemia -- methylene blue -- benzocaine -- cyanosis; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000000800
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : Abstract: Benzocaine is a common topical anesthetic that has the ability to induce methemoglobinemia (MetHgb) in large doses. We describe a 4-year-old girl who received a standard dose of topical benzocaine to her gastrostomy mucosa that resulted in rapid, severe MetHgb. She required intubation, mechanical ventilation, and multiple doses of methylene blue for treatment. The resultant tissue hypoxia from MetHgb caused profound confusion, cyanosis, and myocardial infarction. Although the patient did not sustain any permanent disability, this case demonstrates the need for emergency providers to rapidly identify and treat MetHgb to reverse tissue hypoxia and prevent long-term sequelae.