GeneralReview Article

Lidocaine Induced Methemoglobinemia: A Clinical Reminder

Mark Barash, DO; Keith A. Reich, DO, RhMSUS; and Dennis Rademaker, DO
Notes and Affiliations
Notes and Affiliations

Received: May 16, 2014

Accepted: October 2, 2014

Published: February 1, 2015

J Osteopath Med; 115(2): 94-98

Methemoglobinemia is a rare condition in which the iron in hemoglobin is stabilized in the ferric (Fe3+) form, making it unable to bind oxygen and leading to tissue hypoxia and possibly death. The condition may be hereditary or acquired, the latter resulting from ingestion or application of common oxidizing agents such as lidocaine. As management of methemoglobinemia depends on prompt recognition, clinicians who administer or prescribe oxidizing agents must be aware of the clinical symptoms of methemoglobinemia, including cyanosis, pulse oximetry values that do not respond to increased oxygen delivery, and altered mental status. Currently, methylene blue is the drug of choice for the management of methemoglobinemia.

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