Umar Anam, Bilal Muhammad, Jawed Bilal, Faquih Amber E
Internal Medicine, Ascension St. Vincent's Birmingham, Birmingham, USA.
Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Cureus. 2024 Aug 27;16(8):e67949. doi: 10.7759/cureus.67949. eCollection 2024 Aug.
Benzocaine-induced methemoglobinemia is a rare complication associated with benzocaine, a local anesthetic known for its rapid pain relief. Acquired methemoglobinemia occurs when hemoglobin is oxidized to a ferric state, impairing oxygen binding. This condition can lead to respiratory distress and potentially fatal outcomes if not promptly diagnosed and treated. We present the case of a 61-year-old Caucasian female admitted with respiratory distress after lumbar stenosis surgery. She developed acute hypoxemic respiratory failure due to pneumonia. Although initially responsive to antibiotics and oxygen, her condition worsened overnight despite non-invasive bilevel-positive airway pressure (BiPAP) therapy. The use of benzocaine spray for throat pain led to suspected methemoglobinemia. She was treated with high-dose vitamin C and methylene blue, resulting in significant improvement. This case report aims to raise awareness among healthcare workers and emphasizes that timely recognition and management are crucial for better outcomes.
苯佐卡因诱导的高铁血红蛋白血症是一种与苯佐卡因相关的罕见并发症，苯佐卡因是一种以快速缓解疼痛而闻名的局部麻醉剂。当血红蛋白被氧化成三价铁状态时，就会发生获得性高铁血红蛋白血症，从而损害氧结合能力。如果不及时诊断和治疗，这种情况可能导致呼吸窘迫并可能产生致命后果。我们报告一例61岁白人女性，在腰椎管狭窄症手术后因呼吸窘迫入院。她因肺炎发展为急性低氧性呼吸衰竭。尽管最初对抗生素和氧气有反应，但尽管采用了无创双水平气道正压通气（BiPAP）治疗，她的病情仍在一夜之间恶化。使用苯佐卡因喷雾剂治疗咽痛导致疑似高铁血红蛋白血症。她接受了高剂量维生素C和亚甲蓝治疗，病情显著改善。本病例报告旨在提高医护人员的认识，并强调及时识别和处理对于取得更好的治疗效果至关重要。
