The Incidence of Methemoglobinemia Due to Prilocaine Use in Circumcision/Prilokain ile Yapilan Sunnetlerde Methemoglobinemi Insidansi

Citation metadata

Authors: Deniz Arslan, Guner Yildiz and Mehmet Oguz Sahin
Date: Mar. 2019
From: Journal of Urological Surgery(Vol. 6, Issue 1)
Publisher: Galenos Yayinevi Tic. Ltd.
Document Type: Report
Length: 2,757 words

Main content

Abstract :

Objective: Local anesthesia with prilocaine is widely used in circumcision procedures. However, the incidence of methemoglobinemia due to prilocaine use during these procedures remains unknown. Therefore, this retrospective study was planned to determine the possibility of development of prilocaine-associated methemoglobinemia during circumcision. Materials and Methods: Medical records of 2.431 patients who were circumcised between 2008 and 2015 in University of Health Sciences, Izmir Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Turkiye, were evaluated. Prior to all circumcision procedures, 1.5 mg/kg of local anesthetic was subcutaneously administered to the penis root at 4-5 points from a 20 mL vial containing 400 mg (20 mg/mL) of prilocaine (2%). Results: Of the 2.431 patients included in the study, two (0.008%) developed methemoglobinemia requiring treatment. According to the medical records, five patients (0.021%) developed mild bruising on the hands, feet and sides of the lips. Conclusion: Prilocaine is more frequently encountered as a cause of acquired methemoglobinemia in newborns and children compared to adults. Determining the causative factor for methemoglobinemia and undertaking early and effective application of methylene blue or ascorbic acid can be life-saving. Keywords: Prilocaine, Circumcision, Methemoglobinemia, Local anesthesia, Complications Amac: Sirkumsizyon isjeminde prilokain ile lokal anestezi uygulamasi yaygin olarak kullanilmaktadir. Sirkumsizyon esnasinda prilokain kullanimina bagli methemoglobinemi insidansi bilinmemektedir. Bu retrospektif calisma sirkumsizyon sirasinda kullanilan prilokaine bagli methemoglobinemi gelisme olasiligini ortaya koymak amaciyla planlanmistir. Geree ve Yontem: Saglik Bilimleri Universitesi, Izmir Dr. Suat Seren Gogus Hastaliklari ve Cerrahisi Egitim ve Arastirma Hastanesi, Uroloji Klinigi'ne 2008-2015 arasinda gelen 2431 hastanin dosyalari incelendi. Tum sirkumsizyon islemlerinden once, 20 mL'lik her flakonda 400 mg (20 mg/mL) prilokain (%2) iceren lokal anestezik 1,5 mg/kg olarak penis kokune 4-5 noktadan deri altina uygulandi. Bulgular: Saglik Bilimleri Universitesi, Izmir Dr. Suat Seren Gogus Hastaliklari ve Cerrahisi Egitim ve Arastirma Hastanesi, Uroloji Klinigi'ne 2008-2015 arasinda gelen 2431 hastanin dosyalari incelendi. Calismaya dahil edilen 2431 hastadan iki hastada (%0,008) tedavi gerektiren methemoglobinemi gelisti. Bes hastada (%0,021) ise el, ayak ve dudak kenarlarinda hafif duzeyde morarma oldugu anamnezde tespit edildi. Sonuc: Yenidogan ve cocuklarda edinsel methemoglobinemi olgularinin eriskine oranla gorece sik methemoglobinemi sebeplerinden biri olarak karsimiza cikmistir. Methemoglobinemiye neden olan faktorun saptanmasi, erken ve etkin sekilde askorbik asit veya metilen mavisi uygulanmasi yasam kurtarici olmaktadir. Anahtar Kelimeler: Prilokain, Sirkumsizyon, Methemoglobinemi, Lokal anestezi, Komplikasyon

Source Citation

Source Citation
Arslan, Deniz, et al. "The Incidence of Methemoglobinemia Due to Prilocaine Use in Circumcision/Prilokain ile Yapilan Sunnetlerde Methemoglobinemi Insidansi." Journal of Urological Surgery, vol. 6, no. 1, 2019, p. 38+. Accessed 3 Dec. 2020.
  

Gale Document Number: GALE|A583655908