Anesthesiology and Pain Medicine

Published by: Kowsar
Uncorrected Proof scheduled for 9 (3)

Prevalence of Abnormal Methemoglobinemia and Its Determinants in Patients Receiving Nitroglycerin During Anesthesia

Farsad Imani 1 , Alireza Behseresht 1 , Pejman Pourfakhr 1 , Reza Shariat Moharari 1 , Farhad Etezadi 1 and Mohamadreza Khajavi 1 , *
Authors Information
1 Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
Article information
  • Anesthesiology and Pain Medicine: In Press (In Press); e85852
  • Published Online: June 3, 2019
  • Article Type: Research Article
  • Received: October 28, 2018
  • Revised: April 19, 2019
  • Accepted: April 28, 2019
  • DOI: 10.5812/aapm.85852

To Cite: Imani F, Behseresht A, Pourfakhr P, Shariat Moharari R, Etezadi F, et al. Prevalence of Abnormal Methemoglobinemia and Its Determinants in Patients Receiving Nitroglycerin During Anesthesia, Anesth Pain Med. Online ahead of Print ; In Press(In Press):e85852. doi: 10.5812/aapm.85852.

Copyright © 2019, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Mansouri A, Lurie AA. Concise review: Methemoglobinemia. Am J Hematol. 1993;42(1):7-12. doi: 10.1002/ajh.2830420104. [PubMed: 8416301].
  • 2. Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: Etiology, pharmacology, and clinical management. Ann Emerg Med. 1999;34(5):646-56. doi: 10.1016/S0196-0644(99)70167-8. [PubMed: 10533013].
  • 3. Haymond S, Cariappa R, Eby CS, Scott MG. Laboratory assessment of oxygenation in methemoglobinemia. Clin Chem. 2005;51(2):434-44. doi: 10.1373/clinchem.2004.035154. [PubMed: 15514101].
  • 4. Miller DR. Hemoglobinopathies in children. Massachusetts: PSG Publishing; 1980.
  • 5. Firth PG, Head CA. Sickle cell disease and anesthesia. Anesthesiology. 2004;101(3):766-85. doi: 10.1097/00000542-200409000-00027. [PubMed: 15329603].
  • 6. Anderson CM, Woodside KJ, Spencer TA, Hunter GC. Methemoglobinemia: An unusual cause of postoperative cyanosis. J Vasc Surg. 2004;39(3):686-90. doi: 10.1016/j.jvs.2003.08.023. [PubMed: 14981472].
  • 7. Curry S. Methemoglobinemia. Ann Emerg Med. 1982;11(4):214-21. doi: 10.1016/s0196-0644(82)80502-7.
  • 8. Guay J. Methemoglobinemia related to local anesthetics: A summary of 242 episodes. Anesth Analg. 2009;108(3):837-45. doi: 10.1213/ane.0b013e318187c4b1. [PubMed: 19224791].
  • 9. Shadnia S, Rahimi M, Moeinsadat M, Vesal G, Donyavi M, Abdollahi M. Acute methemoglobinemia following attempted suicide by Dapson. Arch Med Res. 2006;37(3):410-4. doi: 10.1016/j.arcmed.2005.06.010. [PubMed: 16513495].
  • 10. Sin DD, Shafran SD. Dapsone- and primaquine-induced methemoglobinemia in HIV-infected individuals. J Acquir Immune Defic Syndr Hum Retrovirol. 1996;12(5):477-81. doi: 10.1097/00042560-199608150-00006. [PubMed: 8757424].
  • 11. Falkenhahn M, Kannan S, O'Kane M. Unexplained acute severe methaemoglobinaemia in a young adult. Br J Anaesth. 2001;86(2):278-80. doi: 10.1093/bja/86.2.278. [PubMed: 11573675].
  • 12. Divakaran S, Loscalzo J. The role of nitroglycerin and other nitrogen oxides in cardiovascular therapeutics. J Am Coll Cardiol. 2017;70(19):2393-410. doi: 10.1016/j.jacc.2017.09.1064. [PubMed: 29096811]. [PubMed Central: PMC5687289].
  • 13. Cortazzo JA, Lichtman AD. Methemoglobinemia: A review and recommendations for management. J Cardiothorac Vasc Anesth. 2014;28(4):1043-7. doi: 10.1053/j.jvca.2013.02.005. [PubMed: 23953868].
  • 14. Shadnia S, Soltaninejad K, Hassanian-Moghadam H, Sadeghi A, Rahimzadeh H, Zamani N, et al. Methemoglobinemia in aluminum phosphide poisoning. Hum Exp Toxicol. 2011;30(3):250-3. doi: 10.1177/0960327110384287. [PubMed: 20889582].
  • 15. Atyabi N, Yasini SP, Jalali SM, Shaygan H. Antioxidant effect of different vitamins on methemoglobin production: An in vitro study. Vet Res Forum. 2012;3(2):97-101. [PubMed: 25653754]. [PubMed Central: PMC4312803].
  • 16. Mostafazadeh B, Pajoumand A, Farzaneh E, Aghabiklooei A, Rasouli MR. Blood levels of methemoglobin in patients with aluminum phosphide poisoning and its correlation with patient's outcome. J Med Toxicol. 2011;7(1):40-3. doi: 10.1007/s13181-010-0121-7. [PubMed: 21057909]. [PubMed Central: PMC3614104].
  • 17. Firoozabadi AS, Nasri-Nasrabadi Z, Marashi SM. Management of indoxacarb poisoning in a regional setting. Indian J Crit Care Med. 2016;20(10):627-8. doi: 10.4103/0972-5229.192067. [PubMed: 27829724]. [PubMed Central: PMC5073783].
  • 18. Vallurupalli S, Manchanda S. Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures. Local Reg Anesth. 2011;4:25-8. doi: 10.2147/LRA.S22711. [PubMed: 22915889]. [PubMed Central: PMC3417969].
  • 19. Kaplan KJ, Taber M, Teagarden JR, Parker M, Davison R. Association of methemoglobinemia and intravenous nitroglycerin administration. Am J Cardiol. 1985;55(1):181-3. doi: 10.1016/0002-9149(85)90324-8. [PubMed: 3917597].
  • 20. Paris PM, Kaplan RM, Stewart RD, Weiss LD. Methemoglobin levels following sublingual nitroglycerin in human volunteers. Ann Emerg Med. 1986;15(2):171-3. doi: 10.1016/S0196-0644(86)80014-2. [PubMed: 3080924].
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments