tailieunhanh - Báo cáo y học: " Methemoglobinemia presenting in a circumcised baby following application of prilocaine: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Methemoglobinemia presenting in a circumcised baby following application of prilocaine: a case report. | Ozdogan et al. Journal of Medical Case Reports 2010 4 49 http content 4 1 49 JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Methemoglobinemia presenting in a circumcised baby following application of prilocaine a case report Hatice Ozdogan Selcan Osma Gozde B Aydin Avni Dinc Gulten Ozgun Abstract Introduction Local anesthesia with prilocaine has become a routine part of ambulatory circumcision procedures. Methemoglobinemia is a rare but potentially lethal complication of local anesthetics. Case presentation We report the case of a 40-day-old Turkish boy who presented with cyanosis after receiving local anesthesia with prilocaine. His methemoglobin level revealed severe methemoglobinemia methemoglobin 44 . His cyanosis resolved after intravenous administration of methylene blue. Conclusion Although the association between prilocaine use and methemoglobinemia has generally restricted the use of prilocaine in babies it is still widely used in ambulatory procedures especially during circumcision in the neonatal period. Prilocaine should not be used in babies who are less than 3 months old because of the risk of methemoglobinemia other local anesthetics may be used for this age group. Furthermore general anesthesia by mask ventilation may be favored for babies less than 3 months of age instead of local anesthetics. Introduction Circumcision is the surgical removal of the foreskin of the glans penis. Newborns undergoing circumcision demonstrate objective measurable evidence of pain yet the procedure is often performed without analgesia. Newborn circumcision is reported to be the most common elective surgical procedure performed on infants in the United States 1 . There is still significant controversy regarding the benefits and risks of newborn circumcision. In recent years a number of authors have reported medical benefits of newborn circumcision including a decrease in the number of infants with urinary tract infections .