Two Cases of Methemoglobinemia Caused by Prilocaine, A Local Anesthetic

Abstract

In situations of methemoglobinemia, elevated amounts of methemoglobin decrease hemoglobin's ability to bind oxygen. Cases of methemoglobinemia may appear with a mild or severe presentation at emergency departments. This disorder can be inherited or acquired. In the initial phase of treatment, intravenous administration of methylene blue is preferable. This methemoglobinemia may be caused by prilocaine, one of the local anesthetics used for surgical procedures. This paper attempts to describe the examination, diagnostic, and treatment processes of two patients who presented to the emergency room with cyanosis and shortness of breath following the administration of local anesthetic. We aimed to contribute to the literature by explaining the importance of differential diagnosis, clinical findings, and treatment in methemoglobinemia.