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Lidocaine-induced methemoglobinemia: a clinical reminder.

Abstract
Methemoglobinemia is a rare condition in which the iron in hemoglobin is stabilized in the ferric (Fe(3+)) form, making it unable to bind oxygen and leading to tissue hypoxia and possibly death. The condition may be hereditary or acquired, the latter resulting from ingestion or application of common oxidizing agents such as lidocaine. As management of methemoglobinemia depends on prompt recognition, clinicians who administer or prescribe oxidizing agents must be aware of the clinical symptoms of methemoglobinemia, including cyanosis, pulse oximetry values that do not respond to increased oxygen delivery, and altered mental status. Currently, methylene blue is the drug of choice for the management of methemoglobinemia.
AuthorsMark Barash, Keith A Reich, Dennis Rademaker
JournalThe Journal of the American Osteopathic Association (J Am Osteopath Assoc) Vol. 115 Issue 2 Pg. 94-8 (Feb 2015) ISSN: 1945-1997 [Electronic] United States
PMID25637615 (Publication Type: Journal Article, Review)
Copyright© 2015 The American Osteopathic Association.
Chemical References
  • Anesthetics, Local
  • Hemoglobins
  • Oxidants
  • Lidocaine
Topics
  • Anesthetics, Local (adverse effects)
  • Hemoglobins (metabolism)
  • Humans
  • Lidocaine (adverse effects)
  • Methemoglobinemia (blood, chemically induced, therapy)
  • Oxidants (therapeutic use)

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