シタネスト･オクタプレッシンカートリッジ® 使用により 生じたメトヘモグロビン血症の1 例

川井 忠; 角田 直子; 小松 祐子; 平野 大輔; 西平 宗功; 笹村 祐杜; 小幡 健吾; 伊藤 元; 四戸 豊; 千葉 俊美; 佐藤 健一; 山田 浩之

doi:10.20663/iwateshigakukaishi.46.2_85

Case reports

A case of methemoglobinemia due to Citanest and Octapressin^®.

Tadashi KAWAI, Naoko TSUNODA, Yuko KOMATSU, Taifu HIRANO, Soko NISHIHIRA, Yuto SASAMURA, Kengo OBATA, Motoi ITO, Yutaka SHINOHE, Toshimi CHIBA, Kenichi SATO, Hiroyuki YAMADA

Author information

Tadashi KAWAI
Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Naoko TSUNODA
Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Yuko KOMATSU
Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Taifu HIRANO
Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Soko NISHIHIRA
Division of Oral and Maxillofacial Surgery, JA Akitakoseiren Ogachichuo Hospital [Japan]
Yuto SASAMURA
Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Kengo OBATA
Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Motoi ITO
Division of Dental Anesthesiology, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Yutaka SHINOHE
Division of Dental Anesthesiology, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Toshimi CHIBA
Division of Internal Medicine, Department of Oral Medicine, School of Dentistry, Iwate Medical University [Japan]
Kenichi SATO
Division of Dental Anesthesiology, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]
Hiroyuki YAMADA
Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, School of Dentistry [Japan]

Keywords: Methemoglobinemia, propitocaine, complication

JOURNAL FREE ACCESS

2021 Volume 46 Issue 2 Pages 85-90

DOI https://doi.org/10.20663/iwateshigakukaishi.46.2_85

Details

Abstract

Methemoglobinemia is a known complication of local anesthesia use in dental treatment. Methemoglobin reduces oxygen carrying capacity. This report presents a case of methemoglobinemia due to Citanest and Octapressin^® use for mandibular fracture treatment. A 68-year-old man with a diagnosis of mandibular fracture received an intermaxillary fixation before fracture surgery. Then, Citanest and Octapressin^® was used. A total amount of propitocaine was 324 mg. After moving to the operating room, oxygen saturation of peripheral artery decreased. Methemoglobin increased to 6.4% from arterial blood gas analysis, suggesting methemoglobinemia. After that, it improved with oxygen therapy. It is suggested that methemoglobinemia should be noted when using large amounts of propitocaine.

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