ABSTRACT

Local anesthesia with prilocaine is a frequent practice in our country to prevent the pain during circumcision. Prilocaine, in turn, has been demonstrated to potentially cause methemoglobinemia in young babies and newborns. Herein we have presented a case of methemoglobinemia in a three-days-old male newborn hospitalized upon the detection of cyanosis and hypoactivity at the physical examination during follow up period immediately after circumcision under anesthesia with prilocaine. At presentation, the patient had no other sign than those of cyanosis and hypoactivity. Blood methemoglobin level was found to be %32.4, and complete recovery was achieved with treatment. Fetal hemoglobin is more susceptible to ferric state, and the systems to help the prevention of methemoglobinemia are insufficient in early periods of life. For these reasons, it has been discussed here that in young children other anesthetic agents than prilocaine should be used. In this case the search related with this subject has also been discussed in the light of literature knowledge and experience.