title: [Seven cases of parathyroidectomy for secondary hyperparathyroidism using methylene blue: suggestion for the method of methylene blue infusion].
abstract: BACKGROUND
  Intraoperative staining of the parathyroid glands with intravenously administered methylene blue is well described and has been demonstrated as an effective and safe method to facilitate parathyroidectomy. However, there have been several literatures of the development of postoperative neurological toxicity in patients who received methylene blue infusion during parathyroidectomy. We report the method of methylene blue infusion during parathyroidectomy at our institution.
  
  
  METHODS
  Seven adult patients who had undergone parathyroidectomy for secondary hyperparathyroidism associated with chronic renal failure were included in this study. Methylene blue was administered at a constant rate of 4 mg x kg(-1) x hr(-1) with a 1% solution just before the start of operation. The infusion was stopped after the first parathyroid gland was identified.
  
  
  RESULTS
  The mean dose of methylene blue used was 2.2 +/- 0.8 mg x kg(-1). Consequently, the dose of methylene blue by this method could be decreased to less than half of the previously administered dose (6 mg x kg(-1)) at our institution.
  
  
  CONCLUSIONS
  The dose of methylene blue used should be kept to the minimum required to identify the parathyroid glands in each case.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kadoya
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Munehiro
authors.initials: M
authors.lastname: Shiraishi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Uehara
authors.forename: Toshinori
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Keiko
authors.initials: K
authors.lastname: Suetsugu
mesh_terms: D000328:Adult; D000758:Anesthesia; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000601:surgery*; D007262:Infusions, Intravenous / Q000379:methods; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D010280:Parathyroid Glands / Q000378:metabolism / Q000473:pathology*; D016105:Parathyroidectomy / Q000379:methods*; D019990:Perioperative Care; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D008996:Monoamine Oxidase Inhibitors; D008751:Methylene Blue