Acute Cyanosis Developing after the Placement of Central Venous Catheter: Methemoglobinemia Related to Local Prilocaine

Abstract

Introduction: Methemoglobinemia is a rare serious hematological disorder, which is one of the causes of cyanosis in childhood, requiring emergency treatment. It may occur in congenital and acquired circumstances. Congenital methemoglobinemia can be a result of a genetic defect in erythrocyte metabolism and hemoglobin structure.Case Report: Acquired methemoglobinemia occurs in individuals exposed to various oxidant drugs and toxins, but exposure to medication is the most common cause of methemoglobinemia. Local anesthetics such as prilocaine, bupivicaine, and lidocaine are widely used in clinical practice and are common oxidant drugs that cause methemoglobinemia. The diagnosis of methemoglobinemia should be considered in patients presenting with hypoxia and cyanosis. Severity of symptoms correlates with the existing methemoglobin level.Conclusion: In this report, we presented an infant case in which methemoglobinemia developed after the administration of prilocaine prior to the placement of a central venous catheter

Keywords

• Methemoglobin, local nesthetics, cyanosis, ascorbic acid

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