Anesthetic experience: congenital methemoglobinemia due to hemoglobin M

  • Ri, Hyunsu (Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital) ;
  • Park, Youngje (Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital) ;
  • Jeon, Younghoon (Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital)
  • Received : 2021.07.15
  • Accepted : 2021.09.01
  • Published : 2021.10.01


Methemoglobinemia is rare. It is classified into two types: congenital methemoglobinemia and acquired methemoglobinemia. Methemoglobin is incapable of binding oxygen, leading to complications such as cyanosis, dyspnea, headache, and heart failure. In the present case, a 35-year-old man with congenital methemoglobinemia underwent general anesthesia for thyroidectomy. The patient was diagnosed with hemoglobin M at 7 years of age. Ventilation was performed with FiO2 1.0. Arterial blood gas analysis showed that the pH was 7.4, PaO2 439 mmHg, PaCO2 40.5 mmHg, oxyhemoglobin level of 83.2%, and methemoglobin level of 15.5%. The patient had a stable course, although cyanosis was observed during surgery.



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