Methemoglobinemia Associated with Prilocaine Use in Circumcision
Journal Title: Çocuk Acil ve Çocuk Yoğun Bakım Dergisi - Year 2016, Vol 3, Issue 1
Abstract
Methemoglobinemia (MetHb) occurs when the ferric iron with the valence of +2 contained in hemoglobin becomes +3 ferric iron due to various exogenous and endogenous reasons. MetHb shifts the oxygen dissociation curve to the left, and consequently, oxygen cannot be released into the tissues. In this paper, we present two patients who were referred to the pediatric intensive care unit due to hypoxemia after their circumcisions with local anesthesia, and who were eventually diagnosed with methemoglobinemia. There was clinical recovery without sequelae following intravenous methylene blue treatment in both patients. Prilocaine is one of the relatively frequent causes of acquired MetHb in infants and young children. Monitoring methemoglobin levels of the patients for a certain period of time using the non-invasive methods widely accessible today may prevent severe problems of this kind.
Authors and Affiliations
Murat Çağlar Erol, Nuri Alaçakır, Oğuz Dursun
Acute Hemorrhagic Edema of Infancy: A Case Report
Acute hemorrhagic edema in young infants is an isolated cutaneous leukocytoclastic vasculitis characterized by fever, edema and purpuric rashes. Infections, immunization and drugs can be responsible in the etiology of th...
Effects of Vasoactive Drug Use on Hemodynamics in Critical Disease Pediatic Patients
Introduction: The fact that critically ill pediatric patients have hemodynamic and metabolic characteristics different from that in adults plays a key role in the selection of vasoactive agent. The aim of this study was...
A Child with Acute Appendicitis Secondary to Blunt Abdominal Trauma: A Case Report and Review of the Literature
We present a child with abdominal pain and vomiting after blunt abdominal trauma (BAT). He had tenderness, guarding and rebound on the bilateral lower quadrant of the abdomen. He had no abrasion on the abdominal skin sur...
Fatal Complication in Two Cases of Intubation due to Obstructive Respiratory Failure: Negative Pressure Pulmonary Edema
Negative pressure pulmonary edema is a rare but potentially fatal complication that can be seen after upper and lower respiratory tract obstructions. In this paper, we aimed to present two cases of negative pressure pulm...
A Rare Arrhythmia in a Child with Atrial Fibrillation: Ashman Phenomenon
Ashman phenomenon is an aberrant ventricular conduction seen in atrial fibrillation. It is due to a change in the length of QRS complex. It is most often mistaken for a premature ventricular contraction (PVC) or ventricu...