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Titolo:
Toxic methaemoglobin concentrations in premature infants after applicationof a prilocaine-containing cream and peridural prilocaine
Autore:
Frey, B; Kehrer, B;
Indirizzi:
Ostschweizer Kinderspital, Intens Care Unit, CH-9006 St Gallen, Switzerland Ostschweizer Kinderspital St Gallen Switzerland CH-9006 len, Switzerland Ostschweizer Kinderspital, Dept Paediat Surg, CH-9006 St Gallen, Switzerland Ostschweizer Kinderspital St Gallen Switzerland CH-9006 len, Switzerland
Titolo Testata:
EUROPEAN JOURNAL OF PEDIATRICS
fascicolo: 10, volume: 158, anno: 1999,
pagine: 785 - 788
SICI:
0340-6199(199910)158:10<785:TMCIPI>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
METHEMOGLOBINEMIA;
Keywords:
premature infant; methaemoglobinaemia; prilocaine; caudal anaesthesia; critical incident;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
9
Recensione:
Indirizzi per estratti:
Indirizzo: Frey, B Ostschweizer Kinderspital, Intens Care Unit, CH-9006 St Gallen, Switzerland Ostschweizer Kinderspital St Gallen Switzerland CH-9006 tzerland
Citazione:
B. Frey e B. Kehrer, "Toxic methaemoglobin concentrations in premature infants after applicationof a prilocaine-containing cream and peridural prilocaine", EUR J PED, 158(10), 1999, pp. 785-788

Abstract

We report on a retrospective analysis of eight episodes of toxic methaemoglobinaemia in seven premature infants after the combined exposure to prilocaine by EMLA cream (12.5 mg prilocaine) and caudal anaesthesia (5.4-6.7 mg/kg prilocaine). The causative relationship between prilocaine and the infants' deterioration came to our attention through an anonymous voluntary incident-reporting system. The highest methaemoglobin concentration found was 30.6% (5.5 h after anaesthesia). All infants were symptomatic (mottled skin,paleness, cyanosis, poor peripheral perfusion) and two were exposed to unnecessary diagnostic and therapeutic procedures for unspecified deterioration in their conditions. Pharmacokinetic evaluation indicated a single compartment first-order elimination with a methaemoglobin half-life of 8 h. Normal levels ( < 1%) were reached 36 h after exposure to prilocaine. Conclusion Whereas local skin application of prilocaine to premature babies is safe, peridural administration is not because premature infants are more sensitive to methaemoglobin inducing agents and tolerate methaemoglobinaemia less well.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 12:57:53