Spielman F J, Anderson J A, Terry W C
J Oral Maxillofac Surg. 1984 Nov;42(11):740-3. doi: 10.1016/0278-2391(84)90424-5.
A case is reported in which a patient developed cyanosis under general anesthesia due to methemoglobinemia. The cause of the methemoglobinemia was benzocaine applied topically to the pharynx and trachea. When confronted with cyanosis in the absence of cardiac or pulmonary disease, one must seriously consider the diagnosis of methemoglobinemia. Supplemental oxygen should be administered and methylene blue given intravenously. If possible, determination of arterial blood gases should be made to obtain the methemoglobin concentration. Finally, all medical and dental personnel using benzocaine should be aware of the recommended dose and the possible complications of overdosage.
报告了一例患者在全身麻醉下因高铁血红蛋白血症出现发绀的病例。高铁血红蛋白血症的病因是咽部和气管局部应用了苯佐卡因。当面对无心脏或肺部疾病却出现发绀的情况时，必须认真考虑高铁血红蛋白血症的诊断。应给予补充氧气并静脉注射亚甲蓝。如有可能，应进行动脉血气测定以获取高铁血红蛋白浓度。最后，所有使用苯佐卡因的医护人员都应了解推荐剂量及过量使用可能出现的并发症。
