Which of the following local anesthetics is contraindicated for patients diagnosed with COPD?

Prilocaine is contraindicated for patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD) primarily due to its potential for causing methemoglobinemia, a condition characterized by an increased level of methemoglobin in the blood, which can lead to reduced oxygen delivery to tissues. Individuals with COPD already have compromised respiratory function and decreased oxygenation, making them more susceptible to the harmful effects of methemoglobinemia.

In patients with COPD, the respiratory system is already under stress, and the risk of exacerbating oxygenation issues is critical. Other local anesthetics mentioned, such as Lidocaine, Bupivacaine, and Mepivacaine, do not carry the same risk of inducing methemoglobinemia and, therefore, are considered safer alternatives for use in such patients. Consequently, the contraindication of Prilocaine in this patient population underscores the importance of choosing local anesthetics with a favorable safety profile in the context of existing respiratory diseases.