Prilocaine induced methemoglobinemia after tube thoracostomy: case report

Berkant Özpolat; Tutku Soyer; Nesimi Günal; Ünase Büyükkoçak; Murat Çakmak

doi:10.5606/tgkdc.dergisi.2015.10101

Berkant Özpolat¹, Tutku Soyer², Nesimi Günal¹, Ünase Büyükkoçak³, Murat Çakmak⁴

¹Departments of Thoracic Surgery, Medical Faculty of Kırıkkale University, Kırıkkale, Turkey
²Department of Pediatric Surgery, Medical Faculty of Hacettepe University, Ankara, Turkey
³Departments of Anaesthesiology and Reanimation, Medical Faculty of Kırıkkale University, Kırıkkale, Turkey
⁴Department of Pediatric Surgery, Medical Faculty of Ankara University, Ankara, Turkey

DOI : 10.5606/tgkdc.dergisi.2015.10101

Treatment of empyema thoracis in children is generally performed via tube thoracostomy under local anesthesia. Prilocaine, the most preferred local anesthetic agent, is also the most common cause of acquired toxic methemoglobinemia even in therapeutic doses. In this article, we present a 10-year-old boy who developed cyanosis after chest tube insertion under local anesthesia due to empyema and diagnosed as toxic methemoglobinemia. Methemoglobin level was measured as 18.7% and patient was successfully treated with ascorbic acid.

Keywords : Ascorbic acid; chest tube; methemoglobinemia; prilocaine

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