A Case Report of Prilocaine-Induced Methemoglobinemia after Liposuction Procedure

Abstract EN

Prilocaine-induced methemoglobinemia is a rarely seen condition.

In this paper, a case is presented with methemoglobinemia developed secondary to prilocaine use in a liposuction procedure, and the importance of this rarely seen condition is emphasized.

A 20-year-old female patient presented with complaints of prostration, lassitude, shivering, shortness of breath, and cyanosis.

It was learned that the patient underwent nearly 1000 mg prilocaine infiltration 8 hours priorly during a liposuction procedure.

At admission, her blood pressure (130/80 mmHg), pulse rate (140 bpm), body temperature (36°C), and respiratory rate (40/min) were recorded.

The patient had marked acrocyanosis.

The arterial blood gas methemoglobin level was measured as 40%.

The patient received oxygen therapy with a mask and was administered vitamin C in normal saline (500 mg tid), N-acetylcysteine (300 mg tid), and 50 mg 10% methylene blue in the intensive care unit of the internal medicine department.

Methemoglobin level dropped down to 2% after her treatment with methylene blue and she was clinically cured and discharged 2 days later.

Emergency service physicians should remember to consider methemoglobinemia when making a differential diagnosis between dyspnea and cyanosis developing after prilocaine infiltration performed for liposuctions in the adult age group.