Blue dyes, blue people: the systemic effects of blue dyes when administered via different routes.
We report 4 patients who had facial color changes to a blue-green-gray color and decreased oxygen saturation as measured by pulse oximetry. Patient 1 received an intravenous (IV) methylene blue solution during a urologic procedure, and the remaining three patients were administered subcutaneous indigo carmine (patient 2) or Patent Blue (Patients 3 and 4) for axillary lymph node mapping. All patients had above normal methemoglobin levels. Two (Patients 2 and 3) had hypotension, and one (Patient 3) required IV ephedrine to restore hemodynamic stability. Patient 4 had a hypersensitivity reaction characterized by systemic urticaria and blue-colored subintegumentary edema due to the subcutaneous administration.
Yusim
Yakov
Y
Department of Anesthesiology, Sheba Medical Center, Tel-Hashomer 52621, Israel.
Livingstone
David
D
Sidi
Avner
A
D000368:Aged; D002302:Cardiac Output / Q000187:drug effects; D003116:Color; D004342:Drug Hypersensitivity / Q000209:etiology; D005260:Female; D006801:Humans; D007203:Indigo Carmine / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008708:Methemoglobinemia / Q000139:chemically induced; D008751:Methylene Blue / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D012394:Rosaniline Dyes / Q000008:administration & dosage / Q000009:adverse effects*; D012867:Skin
D012394:Rosaniline Dyes; D007203:Indigo Carmine; C008769:sulfan blue; D010100:Oxygen; D008751:Methylene Blue