Methaemoglobinaemia secondary to topical lignocaine/prilocaine in a circumcised neonate

Abstract: The use of topical lignocaine/prilocaine (EMLA^®, Astra Pharmaceuticals, North Ryde, NSW, Australia) for pain relief for neonatal circumcision is becoming more prevalent. Because of immaturity of the methaemoglobin reductase pathway, the neonate is vulnerable to methaemoglobinaemia which is a recognized complication of prilocaine therapy. This is the second report of methaemoglobinaemia due to the use of EMLA^® in association with circumcision during the newborn period.