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Benzocaine-associated methemoglobinemia following bronchoscopy in a healthy research participant.

Author(s): Kuschner WG, Chitkara RK, Canfield J Jr, Poblete-Coleman LM, Cunningham BA, Sarinas PS

Affiliation(s): Veterans Affairs Palo Alto Health Care System, and the Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, California, USA. kuschner@stanford.edu

Publication date & source: 2000-08, Respir Care., 45(8):953-6.

Publication type: Case Reports; Clinical Trial

Benzocaine (ethyl aminobenzoate) is a local anesthetic commonly used to achieve topical anesthesia of the skin and mucous membranes prior to endoscopic procedures. Methemoglobinemia, a condition in which hemoglobin cannot bind and deliver oxygen normally, has been associated with benzocaine use in various patient populations. This is the first report of benzocaine-associated methemoglobinemia occurring in a healthy research participant. The research participant developed a methemoglobin level of 27% and marked cyanosis. No adverse sequelae other than cyanosis were identified. This report extends the population in which benzocaine-associated methemoglobinemia has been described. Additionally, this report supports the observation that methemoglobin levels approaching 30% may be tolerated in otherwise healthy individuals, producing few clinically important effects. Finally, this case also indicates that, in obtaining informed consent for a procedure in which benzocaine will be administered, patients and research participants should be specifically informed of the risk of benzocaine-induced methemoglobinemia. This information is especially important in those settings in which the manufacturer-recommended dose of benzocaine may either intentionally or inadvertently be exceeded.

Page last updated: 2006-01-31

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