Department of Nephrology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
J Pak Med Assoc. 2022 Feb;72(2):363-365. doi: 10.47391/JPMA.3072.
The development of methaemoglobinaemia due to prilocaine, which is used for local anaesthesia, is a rare, life-threatening, but well-known side effect. The development of this side-effect in a pregnant patient with chronic kidney disease can lead to foetal distress. The case presented here is of a 21-year old pregnant female with chronic kidney disease who required haemodialysis in the 22nd week of pregnancy due to the progression to end-stage kidney disease. During haemodialysis, a right jugular tunneled double-lumen catheter was inserted using prilocaine as the local anaesthetic. Prilocaine-induced methaemoglobinaemia was diagnosed. In the 24-hour follow-up, the methaemoglobin level decreased to normal with oxygen supply of 10-15 L/min, 2 units of erythrocyte suspension and accompanying haemodialysis.
普鲁卡因（用于局部麻醉）引起的高铁血红蛋白血症的发展是一种罕见的、危及生命的，但广为人知的副作用。在患有慢性肾病的孕妇中，这种副作用的发展可导致胎儿窘迫。本病例介绍的是一位 21 岁的孕妇，患有慢性肾病，在妊娠第 22 周时进展为终末期肾病，需要进行血液透析。在血液透析过程中，使用普鲁卡因作为局部麻醉剂插入右侧颈静脉隧道式双腔导管。诊断为普鲁卡因诱导的高铁血红蛋白血症。在 24 小时的随访中，通过 10-15 L/min 的氧气供应、2 单位红细胞悬液和伴随的血液透析，高铁血红蛋白水平降至正常。
