Anesthesia · single question

Which local anesthetic is associated with methemoglobinemia in infants when used topically?

  1. Mepivacaine
  2. Lidocaine
  3. Benzocaine
  4. Bupivacaine
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Correct answer: C. Benzocaine

BENZOCAINE (ester type) metabolizes to PABA derivatives that oxidize Hgb Fe2+ → Fe3+ (methemoglobin), impairing O2 transport. Especially dangerous in infants (<2 years) with immature methemoglobin reductase. FDA warns against benzocaine teething gels in children <2.

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