Oral Metilen Mavisi İle Tedavi Edilen, Prilokaine Bağlı Bir Methemoglobinemi Olgusu

Öz

Prilokain, krem veya enjektabl form şeklinde çocuklarda ve erişkinlerde yaygın olarak kullanılan güçlü bir lokal anesteziktir. Literatürde normal dozda prilokainin uygulaması sonrası yan etki olarak oluşan methemoglobinemi ile ilgili çok sayıda vaka sunulmuştur. Tedavide metilen mavisi başarıyla kullanılmaktadır. Bu yazıda lokal anestezi amacıyla prilokain kullanımına bağlı methemoglobinemi gelişen ve oral metilen mavisi ile tedavi edilen bir olgu sunulmuştur.

Anahtar Kelimeler

• Prilokain, methemoglobinemi, metilen mavisi

METHEMOGLOBINEMIA DUE TO PRILOCAINE WHICH TREATED

Öz

Prilocaine is a strong local anesthetic, widely used in children and adults in cream or injectable form. In the literature, there have been many case reports presenting patients developing acquired methemoglobinemia during its usage in therapeutic doses. In this paper, we report an infant who developed methemoglobinemia after prilocaine injection for local anesthesia and treated successfully with oral methylene blue

Anahtar Kelimeler

• Prilocaine, Methemoglobinemia, Methylene blue

Kaynakça

1. Quirolo K, Vichinsky E. Hemoglobin Disorder. In: Behr- man RE, Kleigman RM Jensen HB (eds), Nelson Textbook of Pediatrics. Philadelpiha: Saunders 2004;1623-1634.
2. Kreutz RW, Kinni ME. Life-threatining toxic methemog- lobinemia induced by prilocaine. Oral Surg Oral Med Oral Pathol 1983;56(5):480-2.
3. Bristol I, Brown J, Slomovitz BM, Shannon VR, Eifel PJ. Methemoglobinemia induced by topical vaginal sulfanila- mide cream in a patient with cervical cancer: a case report. Gynecol Oncol 2005;97(3):953-6.
4. Armstrong C, Burak KW, Beck PL. Benzocaine-induced methemoglobinemia: a condition of which all endoscopists should be aware. Can J Gastroenterol 2004;18(10):625-9.
5. Bayard M, Farrow J, Tudiver F. Acute methemoglobinemia after endoscopy. J Am Board Fam Pract 2004;17(3):227-9.
6. Benini D, Vivo L, Fanos V. Acquired methemoglobinemia: a case report. Pediatr Med Chir. 1998;20(6):411-3.
7. Kara A, Yigit S, Aygün C, Oran O. Toxic methemoglobine- mia after injection of prilocaine in a newborn. Turk J Pedi- atr 1998;40(4):589-92.
8. Kayaalp O. Lokal Anestezikler: Rasyonel Tedavi Yönün- den Tıbbi Farmakoloji: Hacettepe-Taş 8. Basım, 1998:797- 810.

9. Lunenfeld E, Kane GC. Methemoglobinemia: sudden dyspnea and oxyhemoglobin desaturation after esophago- duodenoscopy. Respir Care 2004;49(8):940-2.
10. Taddio A, Stevens B, Craig K, Rastogi P, Ben-David S, Shennan A, et al. Efficacy and safety of lidokaine-prilokai- ne cream for pain during circumcision. N Engl J Med 1997; 336(18):1197-201.
11. Kumar AR, Dunn N, Naqvi M. Methemoglobinemia as- sociated with a prilocaine-lidokaine cream. Clin Pediatr 1997;36(4):239-40.
12. Sinisterra S, Miravet E, Alfonso I, Soliz A, Papazian O. Methemoglobinemia in an infant receiving nitric oxide af- ter the use of eutectic mixture of local anesthetic. J Pediatr 2002;141(2):285-6.
13. Hahn IH, Hoffman RS, Nelson LS. EMLA-induced met- hemoglobinemia and systemic topical anesthetic toxicity. J Emerg Med 2004;26(1):85-8.
14. Aydoğan M, Gedikbaşı Toprak D, Türker G, Zengin E, Arı- soy ES, Gökalp AS. Prilokaine bağlı toksik methemoglo- binemide intravenöz askorbik kullanımı: İki vaka takdimi. Çocuk sağlığı ve Hastalıkları Dergisi 2005;48(1):65-8.
15. Gunter JB. Benefit and risks of local anesthetics in infants and children. Pediatr Drugs 2002;4(10):649-72.
16. Gourrier E, Karoubi P, el Hanache A, Merbouche S, Mo- uchnino G, Dhabhi S, et al. Use of EMLA cream in pre- matüre and full-term newborn infants. Arch Pediatr 1995;2(11):1041-6.
17. Brisman M, Ljung BM, Otterbom I, Larsson LE, Adreas- son SE. Methemoglobin formation after the use of EMLA cream in term neonates. Acta Pediatr 1998;87(11): 1191-4.
18. Puthoff TD, Visconti JA, Tschampel MM. Use of Emla pri- or to circumcision. Ann Pharmacother 1996;30(11):1327- 30.
19. Duncan PG, Kobrinsky N. Prilocaine-induced methe- moglobinemia in a newborn infant. Anesthesiology 1983;59(1):75-6.
20. Katz KD, Ruha AM, Curry SC. Aniline and metha- nol toxicity after shoe dye ingestion. J Emerg Med 2004;27(4):367-9.
21. Gülgün M, Kul M, Sarıcı SÜ, Alpay F. Prilocaine Bağlı Methemoglobinemi İki Olgu Sunumu ve Literatüre Bakış. Erciyes Tıp Dergisi 2007;29(4):322-5.
22. Tutak E, Yapıcıoğlu H, Narlı N, Satar M. Prilokain Enjeksi- yonu Sonrası Akkiz Methemoglobinemi Gelişen Bir Yeni- doğan Olgusu. Çukurova Üniversitesi Tıp Fakültesi Dergisi 2002;27(2):145-8.
23. Mansouri A. Methemoglobinemia. Am J Med Sci 1985; 289(5):200-9.