Drug Induced Methemoglobinemia

M. Cobas, H. Olivera, G. Soto, T. Fuhrman

Department of Anesthesia and Perioperative Medicine, University of Miami Miller School of Medicine, University of Miami Hospi- tal, Miami, USA.

DOI: 10.4236/ojanes.2013.33032                

Abstract

The normal presentation of a patient with a drug induced methemoglobinemia is a low pulse oximetry (SpO₂) reading, usually in the mid 80% range, while having a very high PaO₂ on an arterial blood gas (ABG)1. We present a case where the initial ABG showed a very high PaO₂ and a metabolic alkalosis while the SpO₂ fluctuated (85%- 99%). Those findings combined with hemodynamic instability complicated the diagnosis and delayed optimal care.

Keywords

General Anesthesiology Clinical Anesthesiology Anesthetic Monitoring

Conflicts of Interest

The authors declare no conflicts of interest.

References

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[2]	J. Guay, “Methemoglobinemia Related to Local Anesthestics: A Summary of 242 Episodes,” Anesthesia Analgesia, Vol. 108, No. 3, 2009, pp. 837-845.
[3]	E. Annabi and S. J. Barker, “Severe Methemoglobinemia Detected by Pulse Oximetry,” Anesthesia Analgesia, Vol. 108, No. 3, 2009, pp. 898-899.