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一例与局部麻醉药使用相关的快速发作高铁血红蛋白血症病例。

A case of rapid onset methaemoglobinaemia associated with local anaesthetic use.

作者信息

Zadeh K, Bui J, Lakshay J, Vanam V

机构信息

Department of Emergency Medicine Eisenhower Medical Center Rancho Mirage CA USA.

Department of Pulmonary Disease Eisenhower Medical Center Rancho Mirage CA USA.

出版信息

Anaesth Rep. 2025 May 5;13(1):e70013. doi: 10.1002/anr3.70013. eCollection 2025 Jan-Jun.

DOI:10.1002/anr3.70013
PMID:40330898
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12051383/
Abstract

Methaemoglobinaemia is a rare but serious condition which can arise due to the administration of local anaesthetic agents. A 36-year-old woman with metastatic oesophageal adenocarcinoma experienced a rapid onset of methaemoglobinaemia following airway topicalisation with lidocaine and benzocaine sprays for bronchoscopy. The patient was treated with supplementary oxygen, non-invasive respiratory support, methylene blue and ascorbic acid. Early diagnosis and timely treatment of methaemoglobinaemia can result in rapid clinical improvement and prevent long-term complications.

摘要

高铁血红蛋白血症是一种罕见但严重的病症，可因局部麻醉剂的使用而引发。一名36岁的转移性食管腺癌女性患者，在支气管镜检查时使用利多卡因和苯佐卡因喷雾剂进行气道局部麻醉后，迅速出现了高铁血红蛋白血症。该患者接受了补充氧气、无创呼吸支持、亚甲蓝和维生素C的治疗。高铁血红蛋白血症的早期诊断和及时治疗可使临床症状迅速改善，并预防长期并发症。

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本文引用的文献

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Lidocaine-induced methemoglobinemia: a clinical reminder.利多卡因诱发的高铁血红蛋白血症：临床警示
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Methemoglobinemia: a review and recommendations for management.高铁血红蛋白血症：综述与管理建议
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Chest. 2011 Nov;140(5):1342-1350. doi: 10.1378/chest.10-3361.
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Methemoglobinemia related to local anesthetics: a summary of 242 episodes.与局部麻醉药相关的高铁血红蛋白血症：242例病例总结
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Benzocaine and lidocaine induced methemoglobinemia after bronchoscopy: a case report.支气管镜检查后苯佐卡因和利多卡因诱发高铁血红蛋白血症：一例报告
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Benzocaine-induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography.苯佐卡因诱导的高铁血红蛋白血症：经食管超声心动图检查的一种潜在致命并发症。
Tex Heart Inst J. 2003;30(4):308-10.
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Methemoglobinemia complicating topical lidocaine used during endoscopic procedures.
Am J Med. 2001 Aug;111(2):150-3. doi: 10.1016/s0002-9343(01)00763-x.
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Concise review: methemoglobinemia.简明综述：高铁血红蛋白血症
Am J Hematol. 1993 Jan;42(1):7-12. doi: 10.1002/ajh.2830420104.