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Severe methemoglobinemia after dental anesthesia: a warning about propitocaine-induced methemoglobinemia in neonates

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Abstract

Methemoglobinemia is a fatal complication of local anesthesia. We describe a case report of female neonate who developed severe methemoglobinemia after extraction of neonatal teeth conducted with general anesthesia plus local injection of Citanest-Octapressin® (propitocaine of approximately 10 mg/kg). Central cyanosis appeared within an hour after surgery. The percentage of methemoglobin reached up to 43.9%. Not only pediatric dentists but also anesthesiologists generally agree with the idea that local anesthesia provides various benefits in painful procedures in neonates. However, this case may serve as a warning when using Citanest-Octapressin®, which is still commercially available for neonatal patients.

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Authors and Affiliations

  1. Department of Anesthesiology, Japanese Red Cross Society Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, Wakayama, 640-8558, Japan

    Yukari Doko, Hiroshi Iranami, Keisuke Fujii, Akinori Yamazaki & Manabu Shimogai

  2. Department of Anesthesiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8509, Japan

    Hiroshi Iranami & Yoshio Hatano

Authors
  1. Yukari Doko
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  2. Hiroshi Iranami
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  3. Keisuke Fujii
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  4. Akinori Yamazaki
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  5. Manabu Shimogai
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  6. Yoshio Hatano
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Corresponding author

Correspondence to Yukari Doko.

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Doko, Y., Iranami, H., Fujii, K. et al. Severe methemoglobinemia after dental anesthesia: a warning about propitocaine-induced methemoglobinemia in neonates. J Anesth 24, 935–937 (2010). https://doi.org/10.1007/s00540-010-1004-4

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  • DOI: https://doi.org/10.1007/s00540-010-1004-4

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