Benzocaine-induced methemoglobinemia: Experience from a high-volume transesophageal echocardiography laboratory

Gian M. Novaro, Herbert D. Aronow, Michael A. Militello, Mario J. Garcia, Ellen Mayer Sabik

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Benzocaine (ethyl aminobenzoate), a topical anesthetic widely used before transesophageal echocardiography, has been reported to cause acquired methemoglobinemia. The incidence of benzocaineinduced methemoglobinemia in clinical practice, however, has been difficult to estimate. After systematic review of our institutional experience for clinically recognized cases of benzocaine-induced methemoglobinemia in patients undergoing transesophageal echocardiography, we report an estimated incidence of 0.115% (95% confidence interval 0.037-0.269). This report also provides the largest analysis of the incidence of methemoglobinemia in readministration cases. Although controversy remains as to whether this is an idiosyncratic versus dose-related response, a description of purported patient risk factors is included.

Original languageEnglish (US)
Pages (from-to)170-175
Number of pages6
JournalJournal of the American Society of Echocardiography
Issue number2
StatePublished - Feb 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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