Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray

Methemoglobinemia is life-threatening and bears pathognomonic signs difficult to diagnose in real time. Local anesthetics are widely used and are known for eliciting this condition. We report a case of methemoglobinemia secondary to self-administered use of benzocaine spray. A 27-year-old woman was...

Full description

Saved in:
Bibliographic Details
Main Authors: Christopher Hoffman, Hawa Abubakar, Pramood Kalikiri, Michael Green
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2015/685304
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832561255304396800
author Christopher Hoffman
Hawa Abubakar
Pramood Kalikiri
Michael Green
author_facet Christopher Hoffman
Hawa Abubakar
Pramood Kalikiri
Michael Green
author_sort Christopher Hoffman
collection DOAJ
description Methemoglobinemia is life-threatening and bears pathognomonic signs difficult to diagnose in real time. Local anesthetics are widely used and are known for eliciting this condition. We report a case of methemoglobinemia secondary to self-administered use of benzocaine spray. A 27-year-old woman was found to be in respiratory distress during postoperative recovery. After desaturation persisted, arterial blood gas yielded a methemoglobin level of 47%. The patient was successfully treated with intravenous methylene blue. Review of the events revealed self-administered doses of benzocaine spray to alleviate discomfort from a nasogastric tube. We review this case in detail in addition to discussing methemoglobinemia and its relevant biochemistry, pathophysiology, clinical presentation, and medical management. Given the recognized risk of methemoglobinemia associated with benzocaine use, we recommend its removal from the market in favor of safer alternatives.
format Article
id doaj-art-e37c93fad6fa44e9a4010c63214ee991
institution Kabale University
issn 2090-6382
2090-6390
language English
publishDate 2015-01-01
publisher Wiley
record_format Article
series Case Reports in Anesthesiology
spelling doaj-art-e37c93fad6fa44e9a4010c63214ee9912025-02-03T01:25:39ZengWileyCase Reports in Anesthesiology2090-63822090-63902015-01-01201510.1155/2015/685304685304Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine SprayChristopher Hoffman0Hawa Abubakar1Pramood Kalikiri2Michael Green3Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA 19102, USADrexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA 19102, USADrexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA 19102, USADrexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA 19102, USAMethemoglobinemia is life-threatening and bears pathognomonic signs difficult to diagnose in real time. Local anesthetics are widely used and are known for eliciting this condition. We report a case of methemoglobinemia secondary to self-administered use of benzocaine spray. A 27-year-old woman was found to be in respiratory distress during postoperative recovery. After desaturation persisted, arterial blood gas yielded a methemoglobin level of 47%. The patient was successfully treated with intravenous methylene blue. Review of the events revealed self-administered doses of benzocaine spray to alleviate discomfort from a nasogastric tube. We review this case in detail in addition to discussing methemoglobinemia and its relevant biochemistry, pathophysiology, clinical presentation, and medical management. Given the recognized risk of methemoglobinemia associated with benzocaine use, we recommend its removal from the market in favor of safer alternatives.http://dx.doi.org/10.1155/2015/685304
spellingShingle Christopher Hoffman
Hawa Abubakar
Pramood Kalikiri
Michael Green
Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray
Case Reports in Anesthesiology
title Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray
title_full Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray
title_fullStr Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray
title_full_unstemmed Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray
title_short Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray
title_sort nosocomial methemoglobinemia resulting from self administration of benzocaine spray
url http://dx.doi.org/10.1155/2015/685304
work_keys_str_mv AT christopherhoffman nosocomialmethemoglobinemiaresultingfromselfadministrationofbenzocainespray
AT hawaabubakar nosocomialmethemoglobinemiaresultingfromselfadministrationofbenzocainespray
AT pramoodkalikiri nosocomialmethemoglobinemiaresultingfromselfadministrationofbenzocainespray
AT michaelgreen nosocomialmethemoglobinemiaresultingfromselfadministrationofbenzocainespray