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Case Series
Volume 6 Issue 6 - 2021
Prilocaine Induced Methemoglobinemia: Two Case Reports
Sezin Okdemir*
Department of Emergency Medicine, Bilecik Training and Research Hospital, Bilecik, Turkey
*Corresponding Author: Sezin Okdemir, Department of Emergency Medicine, Bilecik Training and Research Hospital, Bilecik, Turkey.
Received: May 04, 2021; Published: June 15, 2021


Background: Methemoglobinemia is a disease that develops as a result of the oxidation of iron in hemoglobin, causing cyanosis due to inadequate oxygen transport to tissues. Prilocaine is a widely used local anesthetic that causes methemoglobinemia in infants, even in therapeutic doses.

Purpose: Here, I present my experience on the intravenous ascorbic acid treatment of two cases that developed cyanosis after prilocaine-induced toxic methemoglobinemia.

Procedures: A five-month-old infant male and a 36-day-old newborn male were admitted to the Emergency Department after circumcision operations. Blood methemoglobin levels were 31.8% and 45.4%, respectively. The patients were treated intravenously with 300 mg/kg ascorbic acid. Cyanosis had completely resolved within 2h.

Main Findings: In toxic methemoglobinemia, intravenous ascorbic acid could be used when methylene blue is not available.

Principle Conclusions: Local anesthetic agents should be used at the lowest effective dose in infants and risk of methemoglobinemia should considered.

Keywords: Methemoglobinemia; Prilocaine; Infant; Cyanosis


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Citation: Sezin Okdemir. “Prilocaine Induced Methemoglobinemia: Two Case Reports”. EC Gastroenterology and Digestive System 6.6 (2021): 39-41.

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