Pediatric intoxication inducing after dental pain management OTC Benzocaine product.

Abstract

Background; Methemoglobinemia is a rare disorder of the blood in which there is an increase in the proportion of hemoglobin present in the oxidized form (methemoglobin). It may be inherited, due either to a deficiency of methemoglobin reductase or to a structural abnormality of hemoglobin, or it may be acquired, usually secondary to exposure to drugs or chemicals that oxidize hemoglobin l. Administration of some local anesthetics such as
benzocaine at large doses may lead to an acute effect of risk Methemoglobinemia.. Presentation ; A 6-years-old child was suffering from dyspnea, headache, and grayish in appearance. The patient was self-treating with an over-the-counter topical oral benzocaine. Treatment; The diagnosis of methemoglobinemia was made in conjunction with consultation with a medical toxicologist and treatment with oxygen and methylene blue as antidote was given 1mg/kg of 1% solution intravenously over 7minutes. The symptoms improved within 30 minutes and child felt markedly better within 1.5 hour. Conclusion; Methylene blue is the specific antidote, but should be reserved for more severe cases.