Journal
CUREUS JOURNAL OF MEDICAL SCIENCE
Volume 13, Issue 10, Pages -Publisher
SPRINGERNATURE
DOI: 10.7759/cureus.18580
Keywords
benzocaine; local anesthetics; methemoglobinemia; transesophageal echocardiography; lidocaine; cyanosis; hypoxia
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This case report describes a 73-year-old male who developed methemoglobinemia after undergoing transesophageal echocardiography. The patient had used topical lidocaine before the procedure and improved with methylene blue treatment. This highlights the importance of considering methemoglobinemia in patients presenting with cyanosis, altered mental status, and hypoxia following endoscopic procedures.
Methemoglobinemia is caused due to an increase in methemoglobin in the blood, impairing oxygen transfer to tissues. Acquired methemoglobinemia is caused by various drugs like local anesthetics, antibiotics, nitrates, nitrites, and food additives. We present a case of a 73-year-old male who presented with cyanosis, altered mental status, and hypoxia following transesophageal echocardiography. Arterial blood gas analysis revealed methemoglobinemia. He had been given topical lidocaine and benzocaine spray before the procedure. He improved after the administration of methylene blue. The case highlights the importance of considering methemoglobinemia in patients presenting with cyanosis, altered mental status, and hypoxia after endoscopic procedures.
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