Author/Authors :
Abdel-Aziz, Samer University of Arkansas for Medical Sciences - Department of Anesthesiology and Pain Medicine, USA , Hashmi, Nazish University of Arkansas for Medical Sciences - Department of Anesthesiology and Pain Medicine, USA , Khan, Sabina University of Arkansas for Medical Sciences - Department of Anesthesiology and Pain Medicine, USA , Ismaeil, Mohamed University of Arkansas for Medical Sciences - Department of Anesthesiology and Pain Medicine, USA
Abstract :
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 Hemoglobin. The patient was successfully treated with methylene blue intravenously and recovered uneventfully. Small amounts of local benzocaine sprayed to numb the airway can cause significant methemoglobinemia that requires immediate recognition and appropriate management.
