What are hematologic manifestations of local anesthetic toxicity?

Updated: Jan 09, 2019
  • Author: Raffi Kapitanyan, MD; Chief Editor: David Vearrier, MD, MPH  more...
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Methemoglobinemia has been frequently reported in association with benzocaine use; however, lidocaine and prilocaine have also been implicated. At low levels (1-3%), methemoglobinemia can be asymptomatic, but higher levels (10-40%) may be accompanied by any of the following complaints:

  • Cyanosis

  • Cutaneous discoloration (gray)

  • Tachypnea

  • Dyspnea

  • Exercise intolerance

  • Fatigue

  • Dizziness and syncope

  • Weakness

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