Rare cause of delirium and hypoxemia after coronary bypass surgery: transdermal lidocaine patch-associated methemoglobinemia

Fidel A. Acevedo, Esther J. Kim, David A. Chyatte, Vance G. Nielsen

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

We present a case of a patient administered parasternal transdermal lidocaine patch therapy as part of a multimodal analgesic regime designed to diminish opioid-associated delirium after coronary bypass surgery. The patient presented with delirium and severe methemoglobinemia (41%) that responded to discontinuation of lidocaine therapy, oxygen administration, and methylene blue administration. The clinical contributors and medicolegal implications of this degree of lidocaine-associated methemoglobin-mediated delirium are presented in the hope of avoiding similar complications in the postoperative setting after coronary bypass surgery.

Original languageEnglish (US)
Pages (from-to)767-769
Number of pages3
JournalInternational Journal of Legal Medicine
Volume132
Issue number3
DOIs
StatePublished - May 1 2018

Keywords

  • Cardiac surgery
  • Delirium
  • Lidocaine
  • Methemoglobin
  • Renal insufficiency

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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