Methæmoglobinæmia Due to Prilocaine

Prilocaine induced methemoglobinemia after tube thoracostomy: case report

“…[2] Drugs that may induce methemoglobinemia are widely used in many clinics, and in most cases, this disorder often goes unrecognized and is thus left untreated. Methemoglobinemia caused by local anesthetics was first reported by Scott [6] in 1964, and there have since been many other cases in the literature. [2][3][4][5][6][7][8][9][10][11] Guay [12] reported that the prilocaine, benzocaine, lidocaine and tetracaine might possibly cause this condition, and of these, the mechanism of prilocaine is understood the most.…”

“…Methemoglobinemia caused by local anesthetics was first reported by Scott [6] in 1964, and there have since been many other cases in the literature. [2][3][4][5][6][7][8][9][10][11] Guay [12] reported that the prilocaine, benzocaine, lidocaine and tetracaine might possibly cause this condition, and of these, the mechanism of prilocaine is understood the most. In these cases, one of the toluidine isomers, ortho-toluidine (o-toluidine), is responsible for the oxidation of hemoglobin to methemoglobin, Methemoglobin consists of hemoglobin in which one or more of the ferrous ions found in the four heme groups have been oxidized to become ferric ions (Fe3+).…”

Comparison of Blood Methemoglobin Levels Between the Patients Who Had Upper Extremity Operation with Regional Intravenous Anesthesia and Axillary Block

“…11 Prilokain uygulamasını takiben, Met-HB düzeyinde yükselme olduğu uzun yıllardır bilinmektedir. 12 İnsanlarda, prilokain ve lidokain hidrolitik aromatik aminlere sırasıyla, o-tolüidin ve 2,6-ksilidin metabolize edilmektedir. Bu metabolitlerin kedi veya farelere intravenöz uygulama sonrasında Met-Hb seviyelerinin artmasına neden olduğu bildirilmiştir.…”

Newer anesthetics end their uses

“…It therefore appears unjustified to end anger the newborn infant by use of this anesthetic, even in a relatively low dose. It also appears as if it would be safest to limit the total dose of this anesthetic to a maximum of 600 mg. 174 …”

“…It therefore appears unjustified to end anger the newborn infant by use of this anesthetic, even in a relatively low dose. It also appears as if it would be safest to limit the total dose of this anesthetic to a maximum of 600 mg. 174 The search for a local anesthetic agent which does not cause local irritation, has low toxicity, acts quickly, and has a relatively long action led Ekenstam and associates 86 to test the nonester, mepivacaine (dl-N-methylpipecolic acid, 2,6 dimethylanilide ), in 1956. It is supplied in 1 and 2 per cent sterile isotonic saline solutions with 0.1 per cent methylparaben as a preservative, or 1.0, 1.5, and 2 per cent in sterile isobaric modified Ringer's solution without a preservative.…”