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A prospective evaluation of benzocaine-associated methemoglobinemia in human beings
1Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, Washington.
Study Objective:
This study determined the frequency and severity of benzocaine-associated methemoglobinemia in routine clinical use.
Design:
Prospective, crossover, convenience study.
Setting:
Gastroenterology clinic at a US Army medical center functioning as a community hospital and tertiary referral center.
Participants:
Healthy adult volunteers and patient volunteers undergoing an upper gastrointestinal endoscopic procedure.
Interventions:
Baseline methemoglobin levels were measured. Subjects then received a 2-second spray of benzocaine to the oropharynx. Venous blood for methemoglobin analysis was collected 20, 40, and 60 minutes after benzocaine dosing and analyzed using a co-oximeter.
Results:
A statistically significant (P < .05) increase in methemoglobin level between baseline (0.8 +/- 0.2%) and 20-, 40-, and 60-minute measurements (0.9 +/- 0.2%) was identified using one-way analysis of variance followed by Fisher's protected least-squares difference.
Conclusion:
A 2-second spray of 20% benzocaine applied to the oropharynx of human beings induces a statistically significant, but clinically insignificant, increase in methemoglobin levels.
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