Benzocaine-induced methaemoglobinaemia: a case study
Stefan Bittmann1, Carsten Krüger
1Department of Pediatrics, Medical and Finance Center Epe, Germany.
British Journal of Nursing (Mark Allen Publishing)
|March 8, 2011
Summary
Topical benzocaine can cause toxic methaemoglobinaemia in children, even days after surgery. Healthcare providers should be aware of this rare but serious adverse effect, especially when applied to wounds.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Toxicology
Background:
- Benzocaine is a common topical anesthetic.
- Benzocaine has been linked to toxic methaemoglobinaemia.
- This condition can occur in healthy individuals without risk factors.
Observation:
- A 5-year-old girl developed toxic methaemoglobinaemia after adenotonsillectomy.
- Topical benzocaine was administered orally for pain relief on the eighth postoperative day.
- Symptoms included cyanosis, dyspnea, and agitation within two hours of application.
Findings:
- The patient's methaemoglobin level was 38.5%.
- Immediate treatment with methylene blue was initiated.
- Symptoms resolved completely within four hours of methylene blue therapy.
Implications:
- Healthcare professionals must recognize the risk of benzocaine-induced methaemoglobinaemia in pediatric patients.
- This risk persists even after a prolonged interval post-surgery.
- Application on wound surfaces may increase the likelihood of adverse events.
