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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Anesthetic agents (local, topical)

3

XIV.a Methemoglobinemia

3
Last update : 23/09/2012
 
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Articaine
1
Benzocaine (incl. topical)
4
Bupivacaine
1
Cetacaine
1
Lidocaine (lignocaine, xylocaine)
3
Nupercaine
1
Prilocaine
1
Tetracaine
1

Publications

Topical Benzocaine and Methemoglobinemia.
American journal of therapeutics 2017;24;e596-e598 2017
Risk of topical anesthetic-induced methemoglobinemia: a 10-year retrospective case-control study.
JAMA internal medicine 2013 May 13;173;771-6 2013 May 13
Methemoglobinemia in bronchoscopy: a case series and a review of the literature.
Journal of bronchology & interventional pulmonology 2013 Jul;20;241-6 2013 Jul
Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures.
Local and regional anesthesia 2011;4;25-8 2011
Severe methemoglobinemia after dental anesthesia: a warning about propitocaine-induced methemoglobinemia in neonates.
Journal of anesthesia 2010 Dec;24;935-7 2010 Dec
Application of topical analgesia in triage: a potential for harm.
The Journal of emergency medicine 2008 Jul;35;39-41 2008 Jul
Benzocaine and lidocaine induced methemoglobinemia after bronchoscopy: a case report.
Journal of medical case reports 2008 Jan 23;2;16 2008 Jan 23
Intraoperative detection of methemoglobinemia in a patient given benzocaine spray to relieve discomfort from a nasogastric tube: a case report.
AANA journal 2008 Apr;76;99-102 2008 Apr
Topical anesthetic sprays directly associated with a serious, sometimes fatal adverse drug reaction: methemoglobinemia.
Journal of emergency nursing 2005 Oct;31;468-9 2005 Oct
Methemoglobinemia secondary to topical benzocaine use in a lung transplant patient.
The Annals of pharmacotherapy 2005 Feb;39;373-6 2005 Feb
The need for caution with topical anesthesia during endoscopic procedures, as liberal use may result in methemoglobinemia.
Journal of clinical gastroenterology 2004 Mar;38;225-9 2004 Mar
Methemoglobinemia caused by topical teething preparation: a case report.
TheScientificWorldJournal 2004 Jul 15;4;517-20 2004 Jul 15
Methemoglobinemia in an infant receiving nitric oxide after the use of eutectic mixture of local anesthetic.
The Journal of pediatrics 2002 Aug;141;285-6 2002 Aug

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