Sünnet öncesi uygulanan lokal prilokaine bağlı methemoglobinemi olgusu

Methemoglobinemi konjenital veya edinsel olarak görülebilmektedir. Edinsel methemoglobinemi birçok maddeye maruziyet sonrası bildirilmiştir. Bu ajanlardan birisi olan prilokain klinik pratikte sık kullanılan bir lokal anesteziktir ve infantlarda tedavi dozunda bile edinsel methemoglobinemiye neden olabilmektedir. Burada prilokain ile lokal anestezi uygulaması sonrası edinsel methemoglobinemi gelişen ve destek tedavi ile düzelen bir olgu sunulmuştur.

Methemoglobinemia after injection of prilocaine for pre-medication of circumcision

Methemoglobinemia may occur in congenital and acquired circumstances. Acquired methemoglobinemia occurs in individuals exposed to a various of agents. Prilocaine is a local anesthetic agent that is widely used in clinical practice, but as well usage at treatment dosage in infancy can cause methemoglobinemia. We report an infant who became methemoglobinemia after injection of prilocaine and spontaneous recovery with supportive treatment.

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  • 1. Honig GR. Hemoglobin disorder. In: Behrman RE, Kleigman RM, Jenson HB (eds). Nelson Textbook of Pediatrics. Philadelpiha: Saunders, 2004, pp:1478–1488.
  • 2. Coleman MD, Coleman NA. Drug-induced methaemoglobinemia. Drug Safety 1996; 14: 394-405.
  • 3. Kara A, Yiğit Ş, Aygün C, Oran O. Toxic methemoglobinemia after injection of prilocaine in a newborn. Turk J Pediatr 1998; 40: 589–592.
  • 4. Taddio A, Stevens B, Craig K, et al. Efficacy and safety of lidocaine-prilocaine cream for pain during circumcision. N Engl J Med 1997; 336: 1197-1201.
  • 5. Kumar AR, Dunn N, Naqvi M. Methemoglobinemia associated with a prilocaine-lidocaine cream. Clin Pediatr 1997; 36: 239-240.
  • 6. Gunter JB. Benefit and risks of local anesthetics in infants and children. Paediatr Drugs 2002; 4: 649-672.
  • 7. Mansouri A. Methemoglobinemia. Am J Med Sci 1985; 289: 200-209.