Methemoglobinemia After Isolated Lidocain Spray: A Rare Phenomenon

Methemoglobinemia is a state recognized by the increased production of met-hemoglobin, which is a form of oxidized hemoglobin, which is unable to bind oxygen. As a result the patient has a functional anemia, in which the remaining oxyhemoglobin has increased oxygen affinity, shifting the oxygen curve to left and perpetuating the impairment of oxygen delivery to tissues. Methemoglobinemia is a rare, but serious cause of hypoxemia, which can be difficult to recognize. It has been traditionally associated with the use of benzocaine class of anesthetic agents and FDA has issued warning for the use of benzocaine class of anesthetic agents for the same reason. It has been very seldom reported with the use of lidocaine class of agents alone. Through this case report we want to emphasize development of methemoglobinemia through the isolated use of lidocaine.