Methemoglobinemia following transesophageal echocardiography: a case report and review

Echocardiography
Swarnalatha BheemReddyDebasish Roychoudhury

Abstract

Benzocaine (ethyl aminobenzoate) is a topical anesthetic widely used for oropharyngeal anesthesia prior to transesophageal echocardiography (TEE). Topical anesthetics have been reported to cause methemoglobinemia, but this adverse event is extremely rare and has not been listed as one of the possible complications of TEE. However, recently the number of published case reports of TEE-associated methemoglobinemia has increased. Since its first description in 1950, 65 cases of methemoglobinemia have been reported including a recent report of five cases from a single center. Physicians who are not familiar with the association of TEE with benzocaine-induced methemoglobinemia may not recognize the idiosyncratic and often nonspecific characteristic of this condition. Recognition is critical, however, since left untreated methemoglobinemia can lead to cardiopulmonary compromise, neurological sequelae, and even death. The current report documents an additional case of TEE-associated methemoglobinemia from a high-volume (8000 cases /year including 400-450 TEE/year) echo lab. A review of the literature suggests that this complication may be more prevalent, than generally appreciated. This case report emphasizes the importance of appropri...Continue Reading

References

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Citations

Oct 9, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Geneviève Côté, André Denault
May 23, 2013·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Mohammed TalebJodi Tinkel
Jul 5, 2011·Burns : Journal of the International Society for Burn Injuries·P PoredosM Derganc
Sep 21, 2010·Anesthesiology Clinics·Deya N Jourdy, Ashutosh Kacker
Jun 15, 2010·Journal of Clinical Anesthesia·Michelle Franz-MontanFrancisco C Groppo
Jul 20, 2010·The American Journal of Emergency Medicine·Amr El-Husseini, Nick Azarov
Jul 6, 2011·Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association·Linda S Von TungelnFrederick A Beland
Apr 11, 2015·Case Reports in Emergency Medicine·Anna Sarah MessmerDirk Bareiss

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