Shamriz Oded, Cohen-Glickman Inbal, Reif Shimon, Shteyer Eyal
Isr Med Assoc J. 2014 Apr;16(4):250-4.
With growing awareness of the importance of pain control in all procedures, the use of lidocaine-prilocaine cream (EMLA) for all ages is increasing. Lidocaine-prilocaine cream has been implicated as a cause of methemoglobinemia. Diagnostic clues may be oxygen-resistant cyanosis and an oxygen "saturation gap" between arterial blood saturation and pulse oximetry. Treatment with intravenous methylene blue is often effective. Since EMLA is often mistakenly considered risk-free it is routinely applied by medical staff in the emergency room. Subsequent to the case of EMLA-induced methemoglobinemia in an 8 year old girl we wish to alert the medical community to this phenomenon, and in this work review the relevant literature.
随着人们对所有手术中疼痛控制重要性的认识不断提高，利多卡因-丙胺卡因乳膏（EMLA）在各年龄段的使用都在增加。利多卡因-丙胺卡因乳膏被认为是导致高铁血红蛋白血症的一个原因。诊断线索可能是对氧抵抗的发绀以及动脉血氧饱和度与脉搏血氧饱和度之间的氧“饱和度差距”。静脉注射亚甲蓝治疗通常有效。由于EMLA常常被错误地认为无风险，所以在急诊室医护人员经常常规使用它。在一名8岁女孩发生EMLA诱导的高铁血红蛋白血症病例之后，我们希望提醒医学界注意这一现象，并在本研究中回顾相关文献。
