From the Guidelines
Benzocaine, also known as Tessalon pearls, is used as a pharyngeal anesthetic agent to facilitate upper endoscopic procedures and reduce discomfort during medical procedures.
Key Points
- Benzocaine has an onset of 5 minutes and a duration of 15-45 minutes 1
- It is used as an adjunct to moderate sedation to reduce discomfort and facilitate procedures such as upper endoscopy 1
- However, benzocaine has been associated with a potentially life-threatening adverse event known as methemoglobinemia, which requires prompt diagnosis and treatment with intravenous methylene blue 1
Usage and Precautions
- Benzocaine can be used for topical anesthesia in office-based dermatologic surgery, but caution must be taken to avoid adverse events such as methemoglobinemia 1
- It is essential to be aware of the potential risks and take necessary precautions when using benzocaine, especially in patients with certain medical conditions or taking specific medications 1
From the Research
Use of Benzocaine (Tessalon) Pearls
- Benzocaine pearls, also known as Tessalon Perles, are used for rapid oral anesthesia in preparation for awake intubations 2.
- They can provide effective topical oral anesthesia, with a shorter time to obtain loss of the gag response compared to other methods 2.
- Benzocaine lozenges, which contain benzocaine, are also used in the treatment of uncomplicated sore throat, providing superior pain relief compared to placebo lozenges 3.
- The use of benzocaine spray for throat pain has been reported to lead to suspected methemoglobinemia, a rare complication associated with benzocaine 4.
- Tessalon Perles have also been involved in cases of overdose, resulting in cardiac arrest and residual blindness 5, and fatalities 6.
Clinical Applications
- Awake intubations: Benzocaine pearls can be used to provide rapid and reliable oropharyngeal anesthesia in preparation for awake intubations 2.
- Sore throat treatment: Benzocaine lozenges can be used to reduce painful pharyngeal discomfort in patients with uncomplicated sore throat 3.
- Local anesthesia: Benzocaine can be used as a local anesthetic to provide rapid pain relief 4.
Safety Considerations
- Methemoglobinemia: Benzocaine can cause methemoglobinemia, a rare complication that can lead to respiratory distress and potentially fatal outcomes if not promptly diagnosed and treated 4.
- Overdose: Tessalon Perles can be involved in cases of overdose, resulting in cardiac arrest and residual blindness 5, and fatalities 6.