Afzal Aasim, Collazo Ruth, Fenves Andrew Z, Schwartz John
Department of Internal Medicine, Baylor University Medical Center at Dallas (Afzal, Collazo, Schwartz); and the Massachusetts General Hospital, Harvard Medical School, Boston Massachusetts (Fenves).
Proc (Bayl Univ Med Cent). 2014 Apr;27(2):133-5. doi: 10.1080/08998280.2014.11929087.
Methemoglobinemia is a rare cause of tissue hypoxia that can quickly become fatal without immediate recognition and prompt treatment. It refers to an increase in methemoglobin in the red blood cells, which can be due to genetic deficiency of the enzymes responsible for reducing hemoglobin or can develop after exposure to oxidizing agents or xenobiotics. Local anesthetics, particularly benzocaine, have long been implicated in the formation of methemoglobin. Benzocaine is used for teething pain as well as before invasive procedures such as intubation and transesophageal echocardiogram. In this case report, we describe a patient with acute appendicitis who developed severe methemoglobinemia following use of benzocaine during an emergent intubation. Our objective is to increase awareness of this rare but potentially fatal complication associated with the use of this anesthetic.
高铁血红蛋白血症是组织缺氧的一种罕见原因，若不立即识别并及时治疗，可迅速致命。它指的是红细胞中高铁血红蛋白增加，这可能是由于负责还原血红蛋白的酶存在基因缺陷，或者在接触氧化剂或外源性物质后发生。局部麻醉剂，尤其是苯佐卡因，长期以来一直被认为与高铁血红蛋白的形成有关。苯佐卡因用于缓解出牙疼痛以及在诸如插管和经食管超声心动图等侵入性操作之前使用。在本病例报告中，我们描述了一名急性阑尾炎患者，在紧急插管期间使用苯佐卡因后发生了严重的高铁血红蛋白血症。我们的目的是提高对与使用这种麻醉剂相关的这种罕见但可能致命的并发症的认识。
