We describe the management of a case of methemoglobinemia secondary to ingestion of indoxacarb, an oxadiazine insecticide.

With growing awareness of the importance of pain control in all procedures, the use of lidocaine-prilocaine cream (EMLA) for all ages is increasing. Lidocaine-prilocaine cream has been implicated as a cause of methemoglobinemia. Diagnostic clues may be oxygen-resistant cyanosis and an oxygen "saturation gap" between arterial blood saturation and pulse oximetry. Treatment with intravenous methyl...

We report a case in which the use of benzocaine spray to facilitate awake fiber optic intubation (FOI) in a patient with a difficult airway caused methemoglobinemia intraoperatively. Local benzocaine was sprayed to numb the patient's airway for a total time of one second, fifteen minutes later SpO2 decreased to 85% on the pulse oximeter. Arterial blood gas (ABG) showed a MetHb of 24.6% of total...

CAN J ANESTH 55: 2 www.cja-jca.org February, 2008 A 60-yr-old lady with HbM Saskatoon and congenital methemoglobinemia was scheduled for mastectomy. Clinical examination confirmed cyanosis but she had no symptoms due to methemoglobinemia and no history suggestive of cardiac or respiratory problems. Her electrocardiogram was normal and arterial blood gas (ABG) values on room air were: pH = 7.52,...