An Open Access Journal from The Law Brigade Publishers 148
Asian Journal of Multidisciplinary Research & Review (AJMRR)
ISSN 2582 8088
Volume 2 Issue 6 [December 2021]
© 2021 All Rights Reserved by The Law Brigade Publishers
CASE REPORT: PEDIATRIC INTOXICATION INDUCING
AFTER DENTAL PAIN MANAGEMENT OTC BENZOCAINE
PRODUCT
Author(s): Dr. Muhi N. Salman & Dr. Amhed H.Al- Saraf
*M.Sc Toxicology, Baghdad College Of Medical Sciences, Baghdad, Iraq
**Pediatric I.C.U Room, Al-Ascan Pediatric Teachiing Hospital, Baghdad, Iraq
ABSTRACT
Local anesthetic systemic toxicity (LAST) is a life-threatening adverse event that may occur
after the administration of local anesthetic drugs through a variety of routes. Increasing use of
local anesthetic in various clinical practice makes contemporary understanding of LAST highly
relevant. 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.
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 , treatment with oxygen supply and methylene blue as antidote was given 1mg/kg
of 1% solution intravenously over 7 minutes. The symptoms improved within 30 minutes and
child felt markedly better within 1.5 hour.
This case report presents a contemporary perspective on the current state of understanding of
LAST, including presentation and treatment .Methylene blue is the specific antidote, but
should be reserved for more severe cases.