经食管超声心动图的一种罕见副作用：局部应用苯佐卡因麻醉引起的高铁血红蛋白血症。

A rare side effect of transesophageal echocardiography: methemoglobinemia from topical benzocaine anesthesia.

作者信息

Jaffery Zehra, Ananthasubramaniam Karthik

机构信息

Department of Internal Medicine, Heart and Vascular Institute, Henry Ford Hospital, 2799 West Grand Boulevard, K-14, Detroit, MI 48202, USA.

出版信息

Eur J Echocardiogr. 2008 Mar;9(2):289-90. doi: 10.1016/j.euje.2006.09.003.

DOI:10.1016/j.euje.2006.09.003

PMID:17074536

Abstract

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.

摘要

背景

苯佐卡因诱发的高铁血红蛋白血症是一种罕见的、可能致命的病症。

病例报告

一名有丙型肝炎病史且有静脉吸毒史的44岁女性因菌血症评估被转诊进行经食管超声心动图检查。在用苯佐卡因喷雾剂进行局部麻醉诱导期间，她出现了发绀。脉搏血氧饱和度测定显示明显的血氧饱和度降低（75%），但与动脉血氧饱和度（99%）不一致。由于临床怀疑，检测了高铁血红蛋白水平，结果为69%。该患者接受了2mg/kg的亚甲蓝静脉注射治疗，症状得以缓解。