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International Journal of Legal Medicine
Published in: International Journal of Legal Medicine 3/2018

01-05-2018 | Case Report

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

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

Published in: International Journal of Legal Medicine | Issue 3/2018

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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.
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Metadata
Title
Rare cause of delirium and hypoxemia after coronary bypass surgery: transdermal lidocaine patch-associated methemoglobinemia
Authors
Fidel A. Acevedo
Esther J. Kim
David A. Chyatte
Vance G. Nielsen
Publication date
01-05-2018
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Legal Medicine / Issue 3/2018
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-017-1682-7

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