Severe Cyanosis: A Life-Threatening Complication with Methemoglobinemia in a Child in a Cosmetic Clinic

Topical anesthetic drugs are widely used clinically during hospital and outpatient procedures and are easily available to the public in a variety of over-the-counter preparations. These anesthetic are especially popular and commonly used in many local dermatological clinics. Yet, topical anesthesia poses certain risks with pediatric patients, especially when a large area is covered. Furthermore, methemoglobinemia is known to occur in elderly patients with preexisting comorbidities who undergo medical procedures with local-anesthetic application, such as nasopharyngeal or oropharyngeal intubation, panendoscopy, or transesophageal echocardiography. This study documents an adolescent female patient who experienced methemoglobinemia with evident cyanosis after topical lidocaine and prilocaine cream were used for laser hair removal surgery. (J Pediatr Resp Dis 2013;9:27-30)