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Methemoglobinemi Yönetimi ve Önlenmesine Yönelik Mezuniyet Öncesi Diş Hekimliği Öğrencilerinin Eğitimsel Altyapısı: Kesitsel Araştırma

Year 2025, Volume: 27 Issue: 2, 127 - 134, 25.08.2025
https://doi.org/10.24938/kutfd.1606748

Abstract

Amaç: Methemoglobinemi, hızlı ve doğru müdahale edilmezse ölümcül olabilir. Nadir görülen bir durum olduğu için, methemoglobinemia ile ilgili bilgilerin kalıcılığını gerçek hasta pratiğiyle artırmak genellikle mümkün değildir. Bu çalışma, diş hekimliği öğrencilerinin methemoglobinemia ile ilgili teorik bilgilerini incelemeyi amaçlamıştır.
Gereç ve Yöntemler: Kesitsel çalışmada, 172 mezuniyet öncesi diş hekimliği öğrencisine, fakülte üyelerinin gözetiminde, 15 sorudan oluşan bir anket yüz yüze uygulanmıştır.
Bulgular: Öğrencilerin, işlem öncesi değerlendirme aşamasında ilgili sorgulamaları yaptıkları ancak methemoglobinemi açısından yüksek riskli hastaları tespit etme konusunda gerekli bilgi seviyelerine sahip olmadıkları açıkça gözlemlenmiştir. Öğrenciler, siyanoz, bulantı, kusma, baş dönmesi ve kanamanın kahverengileşmesi gibi temel akut semptomlar hakkında yeterli bilgiye sahipti. Tedaviye yönelik olarak, sadece oksijen desteği ve metilen mavisi hakkında bilgi seviyelerinin yeterli olduğu gözlemlenmiştir. Her parametrede olmasa da, kadınların ve 5. sınıf öğrencilerinin bilgi düzeylerinin daha yüksek olduğu görülmüştür.
Sonuç: Öğrencilerin, işlem öncesi değerlendirme, semptomlar ve tedavi konularında temel bilgileri yeterli olsa da, bu bilgilerin geliştirilmesi gerekmektedir. Öğrencilerin, hasta ve klinik durum simülasyonları şeklinde seçeneklerle karşılaştıklarında yüksek riskli durumları doğru şekilde belirleyemedikleri açıkça görülmüştür. Methemoglobinemi nadir olsa da, geliştiğinde diş hekimi hemen müdahale edebilmelidir. Diş hekimliği öğrencilerinin methemoglobinemi konusundaki bilgi seviyelerinin artırılması, dental prosedürler sırasında hasta güvenliğini artırmak için hayati öneme sahiptir. Profesyonel tıbbi oyunculuk yardımıyla gerçekleştirilen gerçekçi simülasyonlarla eğitimlerin faydalı olacağı düşünülmüştür

References

  • Ludlow JT, Wilkerson RG, Nappe TM. Methemoglobinemia. Published online August 29, 2022. Accessed April 18, 2023.https://www.ncbi.nlm.nih.gov/books/NBK537317/
  • Burke P, Jahangir K, Kolber MR. Dapsone-induced methemoglobinemia: Case of the blue lady. Can Fam Physician. 2013;59(9):958-961.
  • Mintzer DM, Billet SN, Chmielewski L. Drug-induced hematologic syndromes. Adv Hematol. 2009;2009.
  • Guay J. Methemoglobinemia related to local anesthetics: A summary of 242 episodes. Anesth Analg. 2009;108(3):837-845.
  • Novaro GM, Aronow HD, Militello MA, Garcia MJ, Sabik EM. Benzocaine-induced methemoglobinemia: Experience from a high-volume transesophageal echocardiography laboratory. J Am Soc Echocardiogr. 2003;16(2):170-175.
  • Neuhaeuser C, Weigand N, Schaaf H, et al. Postoperative methemoglobinemia following infiltrative lidocaine administration for combined anesthesia in pediatric craniofacial surgery. Paediatr Anaesth. 2008;18(2):125- 131.
  • Ash-Bernal R, Wise R, Wright SM. Acquired methemoglobinemia: A retrospective series of 138 cases at 2 teaching hospitals. Medicine (Baltimore). 2004;83(5):265-273.
  • Vasters FG, Eberhart LHJ, Koch T, Kranke P, Wulf H, Morin AM. Risk factors for prilocaine-induced methaemoglobinaemia following peripheral regional anaesthesia. Eur J Anaesthesiol. 2006;23(9):760-765.
  • Kaminecki I, Huang D. Methemoglobinemia. Pediatr Rev. 2021;42(3):164-166.
  • Trapp L, Will J. Acquired methemoglobinemia revisited.Dent Clin North Am. 2010;54(4):665-675.
  • Hall DL, Moses MK, Weaver JM, Yanich JP, Voyles JW, Reed DN. Dental anesthesia management of methemoglobinemia-susceptible patients: A case report and review of literature. Anesth Prog. 2004;51(1):24-27.
  • Skold A, Cosco DL, Klein R. Methemoglobinemia: Pathogenesis, diagnosis, and management. South Med J. 2011;104(11):757-761.
  • Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: Etiology, pharmacology, and clinical management. Ann Emerg Med. 1999;34(5):646- 656.
  • Oksuz G, Urfalioglu A, Sekmen T, Akkececi N, Alpay N, Bilal B. Dentists knowledge of lipid treatment of local anaesthetic systemic toxicity. Niger J Clin Pract. 2018;21(3):327-331.
  • Çetinkaya F, Sezgin G, Aslan OM. Dentists’ knowledge about anaphylaxis caused by local anaesthetics. Allergol Immunopathol (Madr). 2011;39(4):228-231.
  • İlhan B, Demir MC. Knowledge of local anesthetic systemic toxicity among emergency medicine physicians: A cross-sectional study. Signa Vitae. 2020;16(2):148-154.
  • Karasu D, Yılmaz C, Özgünay ŞE, Dayıoğlu M, Baytar Ç, Korfalı G. Knowledge of the research assistants regarding local anaesthetics and toxicity. Turkish J Anaesthesiol Reanim. 2016;44(4):201-205.
  • Krishnamurthy M, Venugopal NK, Leburu A, Kasiswamy Elangovan S, Nehrudhas P. Knowledge and attitude toward anaphylaxis during local anesthesia among dental practitioners in Chennai - a cross-sectional study. Clin Cosmet Investig Dent. 2018;10:117-121.
  • Sagir A, Goyal R. An assessment of the awareness of local anesthetic systemic toxicity among multi-specialty postgraduate residents. J Anesth. 2015;29(2):299-302.
  • Bistas E, Sanghavi D. Methylene Blue. Hist Mod Clin Toxicol. Published online September 21, 2022:231-241.
  • Jensen-Gadegaard P, Skjønnemand M, Damgaard-Jensen J, Gottschau B. Limited knowledge of lipid rescue therapy in local anaesthetic systemic toxicity. Dan Med Bull. Published online 2011.
  • Umbreit J. Methemoglobin--it’s not just blue: A concise review. Am J Hematol. 2007;82(2):134-144.
  • Albelaihi HF, Alweneen AI, Ettish A, Alshahrani FA. Knowledge, Attitude, and perceived confidence in the management of medical emergencies in the dental office: A survey among the dental students and ınterns. J Int Soc Prev Community Dent. 2017;7(6):364-369.
  • Zhong BL, Luo W, Li HM, et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: A quick online cross-sectional survey. Int J Biol Sci. 2020;16(10):1745-1752.
  • Erkan GN, Özgül Ö, Önder ME. Knowledge, attitudes and perceptions of dentistry patients and their relatives about the COVID-19 pandemic. The Journal of Kırıkkale University Faculty of Medicine.2021;23(3):617-626.
  • Gazal G, Aljohani H, Al-Samadani KH, Nassani MZ. Measuring the level of medical-emergency-related knowledge among senior dental students and clinical trainers. Int J Environ Res Public Health. 2021;18(13):6889

DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY

Year 2025, Volume: 27 Issue: 2, 127 - 134, 25.08.2025
https://doi.org/10.24938/kutfd.1606748

Abstract

Objective: Without prompt and correct intervention, methemoglobinemia can be fatal. Because of its rarity, it is often impossible to increase the permanence of knowledge about methemoglobinemia with actual patient practice. The study aimed to investigate the theoretical knowledge of pregraduate dental students about methemoglobinemia.
Material and Methods: In the cross-sectional study, a 15- question survey was administered face-to-face to 172 pregraduation students under the supervision of faculty members.
Results: It was clearly observed that the students performed the relevant interrogations in the pre-procedural evaluation stage; however, they did not possess the required level of knowledge in detecting high-risk patients with methemoglobinemia. Students had adequate knowledge about basic acute symptoms such as cyanosis, nausea, vomiting, dizziness, and brown coloration of bleeding. Regarding treatment, it was observed that only the level of knowledge about oxygen support and methylene blue was adequate. Although not in all parameters, women and 5 -grade students had higher levels of knowledge.
Conclusion: Although the basic knowledge of the students was adequate in terms of pre-procedural evaluation, symptoms, and treatment, it should be improved. It was clearly seen that students were unable to make accurate determinations about high-risk situations when faced with options in the form of patient and clinical situation simulations. Although rare, when methemoglobinemia develops, the dentist should intervene immediately. Increasing the knowledge level of dental students about methemoglobinemia is vital to increase patient safety during dental procedures. It was considered that trainings with realistic simulations with the help of professional medical acting would be beneficial.

References

  • Ludlow JT, Wilkerson RG, Nappe TM. Methemoglobinemia. Published online August 29, 2022. Accessed April 18, 2023.https://www.ncbi.nlm.nih.gov/books/NBK537317/
  • Burke P, Jahangir K, Kolber MR. Dapsone-induced methemoglobinemia: Case of the blue lady. Can Fam Physician. 2013;59(9):958-961.
  • Mintzer DM, Billet SN, Chmielewski L. Drug-induced hematologic syndromes. Adv Hematol. 2009;2009.
  • Guay J. Methemoglobinemia related to local anesthetics: A summary of 242 episodes. Anesth Analg. 2009;108(3):837-845.
  • Novaro GM, Aronow HD, Militello MA, Garcia MJ, Sabik EM. Benzocaine-induced methemoglobinemia: Experience from a high-volume transesophageal echocardiography laboratory. J Am Soc Echocardiogr. 2003;16(2):170-175.
  • Neuhaeuser C, Weigand N, Schaaf H, et al. Postoperative methemoglobinemia following infiltrative lidocaine administration for combined anesthesia in pediatric craniofacial surgery. Paediatr Anaesth. 2008;18(2):125- 131.
  • Ash-Bernal R, Wise R, Wright SM. Acquired methemoglobinemia: A retrospective series of 138 cases at 2 teaching hospitals. Medicine (Baltimore). 2004;83(5):265-273.
  • Vasters FG, Eberhart LHJ, Koch T, Kranke P, Wulf H, Morin AM. Risk factors for prilocaine-induced methaemoglobinaemia following peripheral regional anaesthesia. Eur J Anaesthesiol. 2006;23(9):760-765.
  • Kaminecki I, Huang D. Methemoglobinemia. Pediatr Rev. 2021;42(3):164-166.
  • Trapp L, Will J. Acquired methemoglobinemia revisited.Dent Clin North Am. 2010;54(4):665-675.
  • Hall DL, Moses MK, Weaver JM, Yanich JP, Voyles JW, Reed DN. Dental anesthesia management of methemoglobinemia-susceptible patients: A case report and review of literature. Anesth Prog. 2004;51(1):24-27.
  • Skold A, Cosco DL, Klein R. Methemoglobinemia: Pathogenesis, diagnosis, and management. South Med J. 2011;104(11):757-761.
  • Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: Etiology, pharmacology, and clinical management. Ann Emerg Med. 1999;34(5):646- 656.
  • Oksuz G, Urfalioglu A, Sekmen T, Akkececi N, Alpay N, Bilal B. Dentists knowledge of lipid treatment of local anaesthetic systemic toxicity. Niger J Clin Pract. 2018;21(3):327-331.
  • Çetinkaya F, Sezgin G, Aslan OM. Dentists’ knowledge about anaphylaxis caused by local anaesthetics. Allergol Immunopathol (Madr). 2011;39(4):228-231.
  • İlhan B, Demir MC. Knowledge of local anesthetic systemic toxicity among emergency medicine physicians: A cross-sectional study. Signa Vitae. 2020;16(2):148-154.
  • Karasu D, Yılmaz C, Özgünay ŞE, Dayıoğlu M, Baytar Ç, Korfalı G. Knowledge of the research assistants regarding local anaesthetics and toxicity. Turkish J Anaesthesiol Reanim. 2016;44(4):201-205.
  • Krishnamurthy M, Venugopal NK, Leburu A, Kasiswamy Elangovan S, Nehrudhas P. Knowledge and attitude toward anaphylaxis during local anesthesia among dental practitioners in Chennai - a cross-sectional study. Clin Cosmet Investig Dent. 2018;10:117-121.
  • Sagir A, Goyal R. An assessment of the awareness of local anesthetic systemic toxicity among multi-specialty postgraduate residents. J Anesth. 2015;29(2):299-302.
  • Bistas E, Sanghavi D. Methylene Blue. Hist Mod Clin Toxicol. Published online September 21, 2022:231-241.
  • Jensen-Gadegaard P, Skjønnemand M, Damgaard-Jensen J, Gottschau B. Limited knowledge of lipid rescue therapy in local anaesthetic systemic toxicity. Dan Med Bull. Published online 2011.
  • Umbreit J. Methemoglobin--it’s not just blue: A concise review. Am J Hematol. 2007;82(2):134-144.
  • Albelaihi HF, Alweneen AI, Ettish A, Alshahrani FA. Knowledge, Attitude, and perceived confidence in the management of medical emergencies in the dental office: A survey among the dental students and ınterns. J Int Soc Prev Community Dent. 2017;7(6):364-369.
  • Zhong BL, Luo W, Li HM, et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: A quick online cross-sectional survey. Int J Biol Sci. 2020;16(10):1745-1752.
  • Erkan GN, Özgül Ö, Önder ME. Knowledge, attitudes and perceptions of dentistry patients and their relatives about the COVID-19 pandemic. The Journal of Kırıkkale University Faculty of Medicine.2021;23(3):617-626.
  • Gazal G, Aljohani H, Al-Samadani KH, Nassani MZ. Measuring the level of medical-emergency-related knowledge among senior dental students and clinical trainers. Int J Environ Res Public Health. 2021;18(13):6889
There are 26 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Özgün Araştırma
Authors

Gözde Nur Erkan 0000-0002-7055-547X

Mustafa Ercüment Önder 0000-0002-1488-616X

Publication Date August 25, 2025
Submission Date December 30, 2024
Acceptance Date April 6, 2025
Published in Issue Year 2025 Volume: 27 Issue: 2

Cite

APA Erkan, G. N., & Önder, M. E. (2025). DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY. The Journal of Kırıkkale University Faculty of Medicine, 27(2), 127-134. https://doi.org/10.24938/kutfd.1606748
AMA Erkan GN, Önder ME. DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY. Kırıkkale Uni Med J. August 2025;27(2):127-134. doi:10.24938/kutfd.1606748
Chicago Erkan, Gözde Nur, and Mustafa Ercüment Önder. “DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY”. The Journal of Kırıkkale University Faculty of Medicine 27, no. 2 (August 2025): 127-34. https://doi.org/10.24938/kutfd.1606748.
EndNote Erkan GN, Önder ME (August 1, 2025) DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY. The Journal of Kırıkkale University Faculty of Medicine 27 2 127–134.
IEEE G. N. Erkan and M. E. Önder, “DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY”, Kırıkkale Uni Med J, vol. 27, no. 2, pp. 127–134, 2025, doi: 10.24938/kutfd.1606748.
ISNAD Erkan, Gözde Nur - Önder, Mustafa Ercüment. “DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY”. The Journal of Kırıkkale University Faculty of Medicine 27/2 (August2025), 127-134. https://doi.org/10.24938/kutfd.1606748.
JAMA Erkan GN, Önder ME. DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY. Kırıkkale Uni Med J. 2025;27:127–134.
MLA Erkan, Gözde Nur and Mustafa Ercüment Önder. “DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY”. The Journal of Kırıkkale University Faculty of Medicine, vol. 27, no. 2, 2025, pp. 127-34, doi:10.24938/kutfd.1606748.
Vancouver Erkan GN, Önder ME. DO PRE-GRADUATE DENTAL STUDENTS HAVE ADEQUATE EDUCATIONAL BACKGROUND ON THE MANAGEMENT AND PREVENTION OF METHEMOGLOBINEMIA? A CROSS-SECTIONAL STUDY. Kırıkkale Uni Med J. 2025;27(2):127-34.

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