J Korean Acad Pediatr Dent.  2018 Aug;45(3):393-398. 10.5933/JKAPD.2018.45.3.393.

Benzocaine, Methemoglobinemia and Methylene Blue

• Lee J
• Kim J

• KMID: 2438327
• DOI: http://doi.org/10.5933/JKAPD.2018.45.3.393

Abstract

The aim of this review is to introduce about the issue of benzocaine and methemoglobinemia. Through blocking the pain during dental treatment, fear and anxiety of patients will be reduced. Thus, anesthetic agent containing benzocaine is commonly used while controlling the pain of patients during treatment. However, on May 28, 2018, the Ministry of Food and Drug Safety reported a medication safety report about restricting the use of benzocaine-containing agents in infants under 24 months and children. Also, they recommended a cautious use to adolescents and adults to prevent methemoglobinemia (MHb). This report was published due to an advice from Food and Drug Administration (FDA) on May 23, 2018. When using agents containing benzocaine, dentists must consider the probability of MHb and prepare for early diagnosis and appropriate action. Since 1930s, methylene blue is known to cure MHb patients. Therefore, the proper use of methylene blue for emergencies and diagnosis methods for early diagnosis of MHb should be familiar to dentists planning for the use of topical anesthetic agents. Dentists should be trained for emergency situation of MHb caused by the use of benzocaine.

Keyword

Benzocaine; Methemoglobinemia; Methylene Blue; Side Effect

MeSH Terms

Adolescent
Adult
Anesthetics
Anxiety
Benzocaine*
Child
Dentists
Diagnosis
Early Diagnosis
Emergencies
Humans
Infant
Methemoglobinemia*
Methylene Blue*
United States Food and Drug Administration
Anesthetics
Benzocaine
Methylene Blue