Benzocaine spray methemoglobinemia

Topical benzocaine (Hurricaine) induced methemoglobinemia

  1. Conclusion: Topical benzocaine 20% (Hurricaine) spray used in EGDs gets absorbed and can cause methemoglobinemia. Sprays should be limited to 1 second. Prompt treatment with 1% methylene blue IV can be life-saving
  2. Acute methemoglobinemia is a medical emergency that can rapidly become fatal. A substantial number of drugs, including topical preparations, can precipitate this condition. I report a rare example of severe, acute methemoglobinemia caused by oropharyngeal anesthesia with topical benzocaine spray for orogastric intubation
  3. istered use of benzocaine spray
  4. Methemoglobinemia is a potentially severe complication of lidocaine and benzocaine, especially when used concomitantly. Among the acquired causes of methemoglobinemia, although caine-induced methemoglobinemia is rare, it may have a fatal outcome

Methemoglobinemia caused by benzocaine topical spra

Benzocaine Side Effects The topical anesthetic benzocaine is linked to a number of minor side effects, ranging from dry skin to allergies. A serious but rare side effect of this over-the-counter medication is a blood condition called methemoglobinemia Abstract. Topical 20% benzocaine (Hurricaine, Beutlich, Inc., Niles, Ill.) spray is frequently used for oral anesthesia before upper endoscopy. Side effects attributed to this agent are exceedingly rare. The author reports one of these rare complications, drug-induced methemoglobinemia, in a patient with methemoglobin reductase deficiency

Nosocomial Methemoglobinemia Resulting from Self

Benzocaine Spray - patient information, description

Benzocaine and lidocaine induced methemoglobinemia after

  1. Any benzocaine products marketed to these patient populations will be removed from the market by FDA. A standardized methemoglobinemia warning will also be added to prescription local anesthetics. FDA will continue to evaluate the risk of methemoglobinemia associated with benzocaine and provide updated information as necessary
  2. Tell your doctor if you have ever had methemoglobinemia. Different brands of benzocaine oral spray may be for use in different ages of children. Talk with the doctor before giving benzocaine oral spray to a child. Do not eat while your mouth feels numb
  3. Some topical products containing benzocaine are intended to relieve discomfort due to scrapes and insect bites. As a local anesthetic, benzocaine can numb the skin temporarily. (8) Benzocaine can block nerve pain signals. As oral numbing agents, benzocaine can be found as gels, liquids, sprays, and lozenges
  4. istration, due to prolonged absorption of lipophilic agents (benzocaine) from adipose tissue
  5. istration. Do not use benzocaine preparations in children <2 years of age, and use sparingly, only when needed, and not more than 4 times daily in adults and children ≥2 years of age
  6. The topical use of higher concentration (10-20%) benzocaine products applied to the mouth or mucous membranes has been found to be a cause of methemoglobinemia, a disorder in which the amount of oxygen carried by the blood is greatly reduced. This side effect is most common in children under two years of age

of benzocaine spray induced methemoglobinemia was reported3, approximately 200 cases have been documented in the literature. Benzocaine has been reported to cause methemoglobinemia when applied to infants as an ointment or a rectal suppository4,5 and when used topically to the perineal area6. It has also been associated with methemoglobinemia afte Topical 20% benzocaine (Hurricaine, Beutlich, Inc., Niles, Ill.) spray is frequently used for oral anesthesia before upper endoscopy. Side effects attributed to this agent are exceedingly rare. The author reports one of these rare complications, drug-induced methemoglobinemia, in a patient with methemoglobin reductase deficiency. The mechanisms for the development of methemoglobinemia and its. On rare occasions, however, near fatal toxicity can occur. Recently, we cared for a 77-year-old man with methemoglobinemia poisoning, likely due to benzocaine spray. This developed as a complication of the topical administration of benzocaine spray administered in preparation for upper gastrointestinal endoscopy for suspected reflux esophagitis Methemoglobinemia is a rare complication that can occur with the use of benzocaine-containing compounds. Two cases of methemoglobinemia are reported, and the pathophysiology and treatment of methemoglobinemia are reviewed. Both patients received topical 20% benzocaine spray before endoscopy. Immediately following the procedure, there was a reduction in O<sub>2</sub> saturation assessed by. Severe methemoglobinemia resulting from the use of topical benzocaine has been reported in adults as a rare complication. Here we report a case of severe acquired methemoglobinemia resulting from topical use of benzocaine spray during diagnostic upper gastrointestinal endoscopy in a 3-year-old boy with repeated episodes of hematemesis 3 weeks posttonsillectomy

Topical anesthetics, such as benzocaine and lidocaine, are known to occasionally cause toxic methemoglobinemia , which may produce cyanosis. This is considered to be a rare adverse effect with the incidence estimated in the pulmonary literature to be approximately one in every 7,000 bronchoscopies (5) To our knowledge, none of the ingredients other than benzocaine is known to cause methemoglobinemia. The spray (Cetacaine) has been used as a topical anesthetic agent for approximately 7,000 bronchoscopic examinations at our institution since 1968. Neither cyanosis nor methemoglobinemia has been recognized previously Benzocaine-containing products may cause a rare but serious and possibly fatal condition called methemoglobin-emia. Methemoglobinemia is a condition where too much of the hemoglobin in red blood cells becomes unable to bind and carry oxygen. Labels of OTC benzocaine products do not contain warnings about methemoglobinemia. FDA is particularly concerned about the use of OTC benzocaine products. A single spray of benzocaine may induce methemoglobinemia. Clinical symptoms may be observed at relatively low methemoglobin values, including coma at 32.2 and 29.1% in children and adults, respectively Methemoglobinemia typically causes the pulse oximeter to report a saturation of ~82-86% (even if the PaO2 is very high). In a hospital, this will be interpreted as refractory hypoxemia (saturation in 80s despite 100% FiO2). Patients will be treated with high-dose supplemental oxygen and the ICU may be consulted

Since 1977, when the first case of benzocaine spray-induced methemoglobinemia was reported, 3 approximately 200 cases have been documented in the literature, more than half of which were associated with topical anesthetic use for TEE. 1,16-24 Two of the larger studies reviewed 28 478 TEEs 1 and 4336 TEEs 22 and reported topical anesthetic. Notice to Hospitals - Health Canada Issued Important Safety Information on Benzocaine Sprays. November 23, 2006. To: Hospital Chief of Medical Staff. Subject: Association of Benzocaine Sprays with Methemoglobinemia.

Methemoglobinemia due to topical Benzocaine spray is an entity that has been well described in the literature, however it is quite uncommon. Many physicians use benzocain spray for patient comfort during and after several procedures, the most common being Transesophageal Echocardiography, Upper Endoscopy, Bronchoscopy, and Nasogastric Tube. The signs and symptoms of methemoglobinemia occur quickly, often within an hour of exposure to a causative agent. Many local anesthetics can cause methemoglobinemia, and benzocaine is responsible for more than half of the cases of methemoglobinemia related to local anesthetic drugs Few health care professionals realize that topical anesthetic spray can cause methemoglobinemia. We describe a 56-year-old woman who was transferred to our emergency department when severe cyanosis and chest pain developed after administration of topical oropharyngeal benzocaine and lidocaine during outpatient endoscopy

Topical Benzocaine Associated With Methemoglobinemia. April 7, 2011 (UPDATED April 12, 2011) — Topical benzocaine sprays, gels, and liquids used as anesthesia during medical procedures and for. Benzocaine sprays and Methemoglobinemia (MHb) Health Canada and the Canadian Dental Association have both sent out alerts regarding Benzocaine topical anaesthetic sprays and and Methemoglobinemia (MHb). Here's the quote from the CDA alert (dated November 28th): Benzocaine sprays are one of the choices for topical anesthesia in dentistry OBJECTIVE:To report a case of methemoglobinemia secondary to the administration of topical benzocaine spray in an anemic patient who had previously undergone a lung transplant.CASE SUMMARY:A 40-yea..

Methemoglobinemia as a Complication of 20% Benzocaine

  1. Benzocaine-induced methemoglobinemia is a potentially life-threatening complication. We report two cases of methemoglobinemia due to topical benzocaine spray used as premedication for transesophageal echocardiography. A high index of suspicion is needed for this readily treatable condition
  2. The aim of this review is to introduce about the issue of benzocaine and methemoglobinemia. Through blocking the pain during dental treatment, fear and anxiety of patients will be reduced. Thus, anesthetic agent containing benzocaine is commonly used while controlling the pain of patients during treatment. However, on May 28, 2018, the Ministry of Food and Drug Safety reported a medication.
  3. istration (FDA) notified healthcare professionals and patients that it continues to receive reports of methemoglobinemia, a serious and potentially fatal adverse effect, in connection with benzocaine topical products
  4. METHEMOGLOBINEMIA TOXICITY FROM TOPICAL BENZOCAINE SPRAY METHEMOGLOBINEMIA TOXICITY FROM TOPICAL BENZOCAINE SPRAY Shua‐Haim, Joshua R.; Gross, Joel S. 1995-05-01 00:00:00 To the Editor: Topical anesthetic sprays are used very commonly in various surgical and endoscopic procedures. They are usually free of any clinically significant toxicity

Warnings. Benzocaine topical used in the mouth may cause a condition in which the oxygen in your body tissues can become dangerously low. This is a potentially fatal condition called methemoglobinemia (met-HEEM-oh glo-bin-EE-mee-a). Do not use benzocaine topical if you have ever had methemoglobinemia Discussion. Methemoglobinemia is a rare emergency condition divided into 2 categories: hereditary and acquired. Medications such as anilline, benzocaine, dapsone, nitrate, primaquin, and sulfonamides cause acquired methemoglobinemia by directly or indirectly altering ferric ion in hemoglobin to become ferrous ion. 1, 2 Benzocaine spray is the most common topical anesthesia which has been. Topical 20% benzocaine (Hurricaine, Beutlich, Inc., Niles, Ill.) spray is frequently used for oral anesthesia before upper endoscopy. Side effects attributed to this agent are exceedingly rare. The author reports one of these rare complications, drug-induced methemoglobinemia, in a patient with methemoglobin reductase deficiency

Benzocaine-induced methemoglobinemia attributed to topical application of the anesthetic in several laboratory animal species. American Journal of Veterinary Research, 1993. Thomas Brewer. Judith Davis. Thomas Brewer. Judith Davis. Download with Google Download with Facebook. or Patients using OTC benzocaine gels and liquids should be advised to seek immediate medical attention if signs or symptoms of methemoglobinemia develop. In addition, clinicians should closely monitor patients for the development of methemoglobinemia when benzocaine sprays are used during a procedure Benzocaine is not totally innocuous, however; cases of methemoglobinemia have been reported after the administration of very large doses, especially in unmetered spray form. Benzocaine is available in a variety of preparations; a 20% concentration in the form of an aerosol spray, gel, ointment, paste, and solution is most commonly advocated for.

Severe methemoglobinemia resulting from the use of topical benzocaine has been reported in adults as a rare complication. Here we report a case of severe acquired methemoglobinemia resulting from topical use of benzocaine spray during diagnostic upper gastrointestinal endoscopy in a 3-year-old boy with repeated episodes of hematemesis 3 weeks. Benzocaine 1/9. It is used to ease mouth and throat pain. Rectal: A severe blood problem called methemoglobinemia has happened with drugs Benzocaine 2/9. like this one. The risk may be raised in people who have glucose-6-phosphate Oral spray: Do not breathe in this drug. Breathing in this drug may cause harm or death It is not recommended due to safety concerns related to increased methemoglobinemia risk in infants and children <2 years of age. Sore throat/mouth, gag reflex suppression: Spray 20%: It is used as a topical anesthetic for oral or mucosal areas; It is used for temporary relief of occasional minor irritation and pain with sore mouth and throa Cetacaine is a topical anesthetic indicated for the production of anesthesia of all accessible mucous membrane except the eyes. Cetacaine Spray is indicated for use to control pain or gagging. Cetacaine in all forms is indicated to control pain and for use for surgical or endoscopic or other procedures in the ear, nose, mouth, pharynx, larynx.

Benzocaine spray is used to numb the lining of the mouth and throat before certain medical procedures (e.g., intubation). It is also used to temporarily relieve pain from minor mouth/throat. Acute methemoglobinemia is a medical emergency that can rapidly become fatal. A substantial number of drugs, including topical preparations, can precipitate this condition. I report a rare example of severe, acute methemoglobinemia caused by oropharyngeal anesthesia with topical benzocaine spray.. Each gram of Topex 20% benzocaine topical anesthetic spray contains between 180220 mg benzocaine. Each metered - spray delivers approximately 6.8 mg of benzocaine. 4. CONTRAINDICATIONS Should not be used inindividuals with a known sensitivity to benzocaine or para-aminobenzoic acid (PABA). 5. WARNINGS AND PRECAUTIONS. Methemoglobinemia . Cases. Benzocaine-induced Methemoglobinemia Benzocaine-induced Methemoglobinemia Hegedus, Frederick; Herb, Kathleen 2005-12-01 00:00:00 A case is reported in which a patient developed methemoglobinemia-induced cyanosis while under general anesthesia during surgery for multiple fascial space infections. The cause of methemoglobinemia was 20% benzocaine spray used for local anesthesia before intubation

Benzocaine comes in a variety of preparations including Hurricaine, Cetacaine, Exactacain, and Topex. e above patient self-administered Hurricaine spray (% benzocaine spray(mg/mL)). emanufacturer spackageinsertstates that a - -second spray is equivalent to mL of aerosolized % benzocaine. In terms of dosing, they recommend a . Active Ingredients: Benzocaine (5%) (Oral Anesthetic), Menthol (1%) (Oral Anesthetic) Inactive Ingredients: Alcohol, D&C Yellow No. 10, FD&C Blue No. 1, Flavor, Glycerin, Propylene Glycol, Purified Water, Saccharin Sodium, Sucralose Directions Adults and children 12 years and over: Apply to the affected area (one spray) of thirty minutes. Each 200 mg dose of Cetacaine (Spray or Liquid) contains 28 mg of benzocaine, 4 mg of butamben and 4 mg of tetracaine HCl. WARNINGS AND PRECAUTIONS Methemoglobinemia: Cases of methemoglobinemia have been reported in association with local anesthetic use. Although all patients are at risk fo

Methemoglobinemia leads to rapid oxygen desaturation, requiring prompt recognition and treatment. We present two severely obese patients who developed methemoglobinemia following the use of topical or local anesthetic. This complication was detecte Rynn KO, Jahns BE, and Sabbun R, Acute Myocardial Infarction (AMI) Secondary to Benzocaine Induced Methemoglobinemia, Clin Toxicol, 1995, 33(5):495. Shua-Haim JR and Gross JS, Methemoglobinemia Toxicity From Topical Benzocaine Spray, J Am Geriatr Soc, 1995, 43(5):590 Benzocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body. Benzocaine topical is used to reduce pain or discomfort caused by minor skin irritations, sore throat, sunburn, vaginal or rectal irritation, ingrown toenails, hemorrhoids, and many other sources of minor pain on a surface of the body Benzocaine, được bán dưới tên thương hiệu Orajel và các thương hiệu khác, là một thuốc gây tê cục bộ este thường được sử dụng như một thuốc giảm đau tại chỗ hoặc trong thuốc ho. Nó là thành phần hoạt chất trong nhiều loại thuốc mỡ gây tê không kê đơn như các sản phẩm trị loét miệng benzocaine. ester use limited to topical higher risk of methemoglobinemia (hemoglobin oxidized and less able to release O2) tetracaine + oxymetazoline. recently approved nasal spray no needle anesthesia for maxillary anterior teeth and premolars. epinephrine

FDA acts on OTC benzocaine oral products and Rx local

Benzocaine-Induced Methemoglobinemia : Anesthesia & Analgesi

CaseReport Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray ChristopherHoffman,HawaAbubakar,PramoodKalikiri,andMichaelGree Methemoglobinemia is a serious medical condition characterized by the disrupted binding of oxygen to iron on hemoglobin, with a consequent impaired oxygen delivery to body tissues. Various drugs in.. Earlier that day, the patient underwent endoscopy for evaluation of his symptoms. Notes from the procedure indicate that the patient was premedicated with intraoral benzocaine spray and intravenous midazolam. During the procedure, the patient was noted to turn blue with a oxygen saturation of 86% on room air

FDA Warns of Methemoglobinemia with Benzocaine Topical

  1. Benzocaine is a commonly used topical anaesthetic for mucous membranes prior to transoesophageal echocardiography (TEE). Although generally considered safe, it can on rare occasion lead to life-threatening complications such as methaemoglobinaemia.1. The incidence of benzocaine-induced methaemoglobinaemia in TEE is low
  2. utes to days following the application of the benzocaine spray, with most cases diagnosed within one to two hours (n=55). Because the cases of methemoglobinemia generally occurred while the patients were sedated for a procedure, symptoms experienced by the patients.
  3. benzocaine, each approximately one-half second in duration. The patient's oxygen saturation by pulse oximeter (SpO2) at this point was 96% on room air. After arriving in the operating room, a transtra-Methemoglobinemia is a potential negative side effect associated with the use of benzocaine for topical anes-thesia
  4. Methemoglobinemia is a known and potentially fatal complication of benzocaine spray. This case was the third known case at our institution in the last three years secondary to benzocaine usage. The new multi-wavelength pulse CO-Oximeter enabled us to rapidly confirm the diagnosis and continuously monitor the levels of methemoglobin. The Puls
  5. Benzocaine Hurricaine® Topex® Apply spray for ≤1 second Delivers 45-55mg per spray 1-second spray is designed to deliver 60mg but has been reported to deliver as much as 500mg-3300mg.11,59,67 Toxicity has been observed with normal and excessive number of sprays. Metered dose at 50mg per spray Cetacaine® Apply spray for ≤1 secon

Topical Anesthetic-Induced Methemoglobinemia Advisor

Benzocaine Side Effects, Methemoglobinemia - Parker

The mean: peak methemoglobin level among these individuals was 7.6%. In 5 of the patients with the most severely elevated levels, 20% benzocaine spray (Hurricane Topical Anesthetic spray, Beutlich Pharmaceuticals, Waukegan, IL) was the etiology, associated with a mean peak methemoglobin level of 43.8% The development of methemoglobinemia after treatment with benzocaine sprays may not be related to the amount applied. In many cases, methemoglobinemia was reported following the administration of. Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray Christopher Hoffman, Hawa Abubakar, Pramood Kalikiri, Michael Green; Affiliations Christopher Hoffman Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA 19102, USA. The incidence of benzocaine-induced methemoglobinemia associated with TEE in clinical practice has recently been assessed. In a retrospective study by Novaro et al., 2 the incidence of benzocaine-induced methemoglobinemia associated with TEE in their institution was estimated to be 0.115%, which appears to be higher than previously reported

Reported Adverse Event Cases of Methemoglobinemia

Benzocaine Side Effects Methemoglobinemia Blood Disorde

Benzocaine induced methemoglobinemia is an uncommon, potentially fatal condition. Case report A 44-year-old woman with a history of hepatitis C and intravenous drug use was referred for transesophageal echocardiography for bacteremia evaluation What is benzocaine? Benzocaine (chemical formula C 9 H 11 NO 2) is a widely used local anaesthetic.It is classified as an ester type of local anaesthetic (as opposed to an amide), due to the para-aminobenzoic acid in its structure.. Benzocaine is frequently linked to hypersensitivity reactions.The prevalence of these reactions is thought to be due to the presence of benzocaine in many over-the. Methemoglobinemia, a disorder characterized by the presence of a higher than normal level of methemoglobin in the blood, is a known side effect of benzocaine sprays, but the risk is increased when practitioners use multiple sprays or sprays of longer duration than recommended for susceptible patients.

Symptoms usually appear within minutes to hours of applying benzocaine and can occur either with the first application, or after additional use. For spray, some cases of methemoglobinemia were. Methods: We retrospectively identified all cases of methemoglobinemia that occurred in a university affiliated community hospital from 2001 to 2007. Results: Eleven cases of methemoglobinemia were identified over the 6-year period. Nine (82%) occurred with use of benzocaine spray during transesophageal echocardiography (TEE) Topical benzocaine spray is a local anesthetic agent that is commonly used during transesophageal echocardiography (TEE). This agent is believed to be safe because it has very low systemic absorption. We report a case of life-threatening methemoglobinemia following very minimal dose of benzocaine spray. Introduction / Backgroun In that announcement, titled Benzocaine and Babies: Not a Good Mix, the agency noted that since 2006, it had received 29 reports of benzocaine-gel-related cases of methemoglobinemia. According to the agency, 19 of these most recently reported cases occurred in children, and 15 of the 19 occurred in children under 2 years of age Cetacaine® Topical Anesthetic Spray. (Benzocaine 14.0 %, Butamben 2.0 %, Tetracaine Hydrochloride 2.0 %) Cetacaine is the only Rx topical anesthetic spray indicated for gag reflex suppression. Cetacaine provides a rapid 30 second onset and 30-60 minute duration. Cetacaine's combination of active ingredients is proven more effective than.

Methemoglobinemia as a complication of 20% benzocaine

Cetacaine is an anesthetic that contains the active ingredients of benzocaine at 14%, butamben at 2%, and tetracaine hydrochloride at 2%. Cetacaine also contains small amounts of benzalkonium chloride at 0.5% and 0.005% of cetyl dimethyl ethyl ammonium bromide all in a bland water-soluble base. Although Cetacaine has been widely used in the medical, but mainly dental field it has yet to be. Benzocaine is also sold in other forms such as sore throat lozenges, creams, ointments, and spray solutions. (See the benzocaine spray alert message here) These products are used to relieve pain from a variety of conditions, such as teething, canker sores, toothaches, burns, insect bites, and irritation of the mouth and gums Although the FDA discourages off-label use of benzocaine products, if they are used off label as a spray prior to a procedure (such as transesophageal echocardiogram, endoscopy, or intubation), health care professionals should be aware of the risk of methemoglobinemia and assess the patient for its signs and symptoms Benzocaine-induced clinical methemoglobinemia has been reported in humans,3,6,9-16 dogs,4 cats,7 and sheep,8 and was first recognized in 1950.1 Methemoglobinemia from benzocaine has also been experimentally induced in several laboratory animal species (rats, mice, ferrets, rhesus monkeys, cynomolgus monkeys, owl monkeys, rabbits, and.

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