This month’s case-based question, authored by Blossom Dharmaraj and Deepa Kattail, spotlights methemoglobinemia, a rare but potentially fatal condition that has resurfaced in the headlines following a pediatric dental death. The case explores how nitrous oxide, local anesthetics (such as benzocaine and prilocaine), and other conditions can induce dangerously high levels of methemoglobin in children, especially in dental procedures.

Learn the clinical red flags, diagnostic pitfalls, and treatment strategies. A recent multi-center study further underscores the importance of recognizing this condition in pediatric patients: Sinha N, Lichak B, Thomas NJ, Krawiec C. A Multi-Center Retrospective Database Evaluation of Pediatric Subjects Diagnosed With Methemoglobinemia. Clinical Medicine Insights: Pediatrics. 2024;18. https://doi.org/10.1177/11795565241271678

For a quick clinical refresher, visit the OpenAnesthesia One-Pager on Methemoglobinemia, our SPPM Visual Pearl, and don’t forget to visit the SPPM Question of the Month to test your knowledge.

SPPM Infographic on Methemoglobinemia by Carole Lin MD