Methemoglobinemia due to prilocaine use during jaw deformity surgery: A case report

Abstract Methemoglobinemia is a known complication of local anesthesia use in dental treatment. Methemoglobin reduces oxygen carrying capacity. Since there is also respiratory depression due to swelling during major surgery in the oral region, careful management is necessary if it appears as a postoperative complication. This report presents a case of methemoglobinemia due to prilocaine use during jaw deformity surgery. A 32-year-old woman with a diagnosis of jaw deformity received a Le Fort 1 osteotomy and sagittal split ramus osteotomy under general anesthesia. A total amount of 750 mg prilocaine was used for local anesthetic. Methemoglobin percentage increased up to 12.2 % after operation, but recovered with oxygen therapy, ascorbic acid, and methylene blue administration. It is suggested that methemoglobinemia should be treated as early as possible during oral surgery, in consideration of postoperative respiratory conditions.