Rawla Prashanth, Pradeep Raj Jeffrey
Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ, USA.
Department of Pharmacology, St John's Medical College, Bangalore, India.
J Hematol. 2017 Oct;6(4):87-89. doi: 10.14740/jh325w. Epub 2017 Sep 20.
Benzocaine, a topical anesthetic agent, is widely used during short procedures like endoscopy, endotracheal intubation and likewise. Here we report a case of benzocaine spray-induced methemoglobinemia in an adult male patient during the transesophageal echocardiography (TEE) presenting as hypoxia and improved subsequently in the next 2 h on low-dose intravenous methylene blue. Causality assessment of the adverse event was probable, and preventability assessment was unpreventable. The patient was discharged with no further complications at good health. A relevant etiopathology and managing principles are summarized in this case report such that it serves as an awareness to all medical fraternity about this unexpected yet life-threatening adverse drug reaction to an otherwise safe local anesthetic.
苯佐卡因是一种局部麻醉剂，广泛用于诸如内窥镜检查、气管插管等短时间操作中。在此，我们报告一例成年男性患者在经食管超声心动图检查（TEE）期间因使用苯佐卡因喷雾剂诱发高铁血红蛋白血症，表现为缺氧，随后在低剂量静脉注射亚甲蓝治疗下于2小时内症状改善。该不良事件的因果关系评估为“可能”，可预防性评估为“不可预防”。患者出院时身体健康，无进一步并发症。本病例报告总结了相关的病因病理及处理原则，旨在提高全体医疗界对这种虽意外但危及生命的不良药物反应的认识，而该反应是由一种原本安全的局部麻醉剂引起的。
