Methaemoglobinaemia secondary to topical lignocaine/prilocaine in a circumcised neonate (after use of EMLA cream)

Journal of Paediatrics and Child Health (Australia), Volume 36, Issue 4: Pages 406-407, November 2000.

RTL Couper

Department of Paediatrics,
University of Adelaide,
Women's and Children's Hospital,
Adelaide, South Australia,


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.

Correspondence: R Couper

Senior Lecturer,
Department of Paediatrics,
Women's and Children's Hospital,
University of Adelaide,
72 King William Road,
North Adelaide, South Australia 5006,
Fax: (08) 8204 7031;

RTL Couper, FRACP, Senior Lecturer.

© Royal Australasian College of Physicians


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