The influence of lidocaine topical anesthesia during transesophageal echocardiography on blood methemoglobin level and risk of methemoglobinemia

详细信息    查看全文

• 作者：Dominika Filipiak-Strzecka…
• 关键词：Methemoglobinemia ; Transesophageal echocardiography ; Lidocaine ; Local anesthesia
• 刊名：The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：31
• 期：4
• 页码：727-731
• 全文大小：139 KB
• 参考文献：1.C?té G, Denault A (2008) Transesophageal echocardiography-related complications. Can J Anaesth 55(9):622-47View Article PubMed
  2.Chander K, Lavie CJ, Ventura HO, Milani RV (2003) Benzocaine induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography. Ochsner J 5(2):34-5PubMed Central PubMed
  3.Jacka MJ, Kruger M, Glick N (2006) Methemoglobinemia after transesophageal echocardiography: a life-threatening complication. J Clin Anesth 18(1):52-4View Article PubMed
  4.Umbreit J (2007) Methemoglobin—it’s not just blue: a concise review. Am J Hematol 82(2):134-44View Article PubMed
  5.Guertler AT, Pearce WA (1994) A prospective evaluation of benzocaine-associated methemoglobinemia in human beings. Ann Emerg Med 24(4):626-30View Article PubMed
  6.Darling RC, Roughton FJW (1942) The effect of methemoglobin on the equilibrium between oxygen and hemoglobin. Am J Physiol 137:56-8
  7.Hahn RT, Abraham T, Adams MS, Bruce CJ, Glas KE, Lang RM et al (2014) Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the american society of echocardiography and the society of cardiovascular anesthesiologists. Anesth Analg 118(1):21-8View Article PubMed
  8.Kane GC, Hoehn SM, Behrenbeck TR, Mulvagh SL (2007) Benzocaine-induced methemoglobinemia based on the Mayo Clinic experience from 28 478 transesophageal echocardiograms: incidence, outcomes, and predisposing factors. Arch Intern Med 167(18):1977-982View Article PubMed
  9.Bloom JC, Brandt JT (2001) Toxic responses of the blood. In: Klaassen CD (ed) Casarett and Doull’s toxicology: the basic science of poisons. 6th edn. Mc Graw-Hill,?New York
  10.Lipiec P, P?ońska-Go?ciniak E, Ku?mierek J, P?achcińska A, Stefańczyk L, Majos A et al (2013) Polish clinical forum for cardiovascular imaging. safety of non-invasive cardiovascular imaging techniques. Expert consensus statement of the polish clinical forum for cardiovascular imaging. Kardiol Pol 71(3):301-07View Article PubMed
  11.Vallurupalli S, Manchanda S (2011) Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures. Local Reg Anesth 4:25-8View Article PubMed Central PubMed
  12.Guay J (2009) Methemoglobinemia related to local anesthetics: a summary of 242 episodes. Anesth Analg 108(3):837-45View Article PubMed
  13.Raso SM, Fernandez JB, Beobide EA, Landaluce AF (2006) Methemoglobinemia and CNS toxicity after topical application of EMLA to a 4-year-old girl with molluscum contagiosum. Pediatr Dermatol 23(6):592-93View Article PubMed
  14.Abu-Laban RB, Zed PJ, Purssell RA, Evans KG (2001) Severe methemoglobinemia from topical anesthetic spray: case report, discussion and qualitative systematic review. CJEM 3(1):51-6PubMed
  15.Birchem SK (2005) Benzocaine-induced methemoglobinemia during transesophageal echocardiography. J Am Osteopath Assoc 105(8):381-84PubMed
  16.Chowdhary S, Bukoye B, Bhansali AM, Carbo AR, Adra M, Barnett S et al (2013) Risk of topical anesthetic-induced methemoglobinemia: a 10-year retrospective case-control study. JAMA Intern Med 173(9):771-76View Article PubMed
  17.Aryal MR, Gupta S, Giri S, Fraga JD (2013) Benzocaine-induced methaemoglobinaemia: a life-threatening complication after a transoesophageal echocardiogram (TEE). BMJ Case Rep 16:2013
  18.Higuchi R, Fukami T, Nakajima M, Yokoi T (2013) Prilocaine- and lidocaine-induced methemoglobinemia is caused by human carboxylesterase-, CYP2E1-, and CYP3A4-mediated metabolic activation. Drug Metab Dispos 41(6):1220-230View Article PubMed
  19.Hartman NR, Mao JJ, Zhou H, Boyne MT, Wasserman AM, Taylor K, Racoosin JA, Patel V, Colatsky T (2014) More methemoglobin is produced by benzocaine treatment than lidocaine treatment in human in vitro systems. Regul Toxicol Pharmacol 70(1):182-88View Article PubMed
  20.Byrne MF, Mitchell RM, Gerke H, Goller S, Stiffler HL, Golioto M et al (2004) The need for caution with topical anesthesia during endoscopic procedures, as liberal use may result in methemoglobinemia. J Clin Gastroenterol 38(3):225-29View Article PubMed
  
• 作者单位：Dominika Filipiak-Strzecka (1)
  Jaros?aw D. Kasprzak (1)
  Marta Wiszniewska (2)
  Jolanta Walusiak-Skorupa (2)
  Piotr Lipiec (1)
  
  1. Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Kniaziewicza 1/5, 91-347, Lodz, Poland
  2. Department of Occupational Diseases, Nofer Institute of Occupational Medicine, Lodz, Poland
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Netherlands
• ISSN：1573-0743

文摘

Methemoglobinemia is a relatively rare, but potentially life-threating medical condition, which may be induced by application of topical anaesthetic agents commonly used during endoscopic procedure. The aim of our study was to assess the influence of lidocaine used prior to transesophageal echocardiography (TEE) on the blood level of methemoglobin in vivo. Additionally we attempted to establish the occurrence rate of clinically evident lidocaine-induced methemoglobinemia on the basis of data collected in our institution. We retrospectively analyzed patient records from 3,354 TEEs performed in our echocardiographic laboratory over the course of 13?years in search for clinically evident methemoglobinemia cases. Additionally, 18 consecutive patients referred for TEE were included in the prospective part of our analysis. Blood samples were tested before and 60?min after pre-TEE lidocaine anesthesia application. Information concerning concomitant conditions and pharmacotherapy were also obtained. In 3,354 patients who underwent TEE in our institution no cases of clinically evident methemoglobinemia occurred. In the prospective part of the study, none of 18 patients [16 (89?%) men, mean age 63?±?13] was diagnosed with either clinical symptoms of methemoglobinemia or exceeded normal blood concentration of methemoglobin. Initial mean methemoglobin level was 0.5?±?0.1?% with mild, statistically (but not clinically) significant rise to 0.6?±?0.1?% after 60?min (p?=?0.02). Among the analyzed factors only the relation between the proton pump inhibitors intake and methemoglobin blood level rise was identified as statistically relevant (p?=?0.03). In adults, pre-TEE lidocaine anesthesia with recommended dosage results in significant increase in methemoglobin blood level, which however does not exceed normal values and does not result in clinically evident methemoglobinemia.