title: Methylene blue and parathyroid adenoma localization: Three new cases of a rare cutaneous complication.
abstract: Methylene blue has been safely used for the localization of parathyroid glands during parathyroidectomy, and only a few adverse effects have been documented. Methylene blue administration as a cause of pulse-oximetry-related skin injury is extremely rare. We describe 2 such cases in patients who developed a blister on the second digit at the pulse oximetry site after an uncomplicated excision of a parathyroid adenoma. In another case, a patient became bradycardic intraoperatively; she was successfully resuscitated, but she incurred a second-degree burn at the pulse oximetry site. In all 3 cases, the burns resolved with local wound care. We publish this report to alert surgeons and anesthesiologists to the risk of skin complications with the use of high-dose intraoperative methylene blue.
authors.affiliation: Corresponding author: Kristen Pytynia, MD, MD Anderson Regional Care Center, 19770 Kingsland Blvd., Unit 2050, Suite 100, Houston, TX 77094. Email: kbpytynia@mdanderson.org From North Shore Ear, Nose and Throat Associates, Highland Park, Ill. (Dr. Lieberman); the Department of Otolaryngology, University of Illinois at Chicago College of Medicine (Dr. Thambi); and the Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston (Dr. Pytynia).
authors.forename: Elliot D
authors.initials: ED
authors.lastname: Lieberman
authors.forename: Rakhi
authors.initials: R
authors.lastname: Thambi
authors.forename: Kristen B
authors.initials: KB
authors.lastname: Pytynia
mesh_terms: D000236:Adenoma / Q000601:surgery; D000328:Adult; D000368:Aged; D002057:Burns, Chemical / Q000209:etiology*; D005260:Female; D005383:Finger Injuries / Q000139:chemically induced*; D006801:Humans; D008751:Methylene Blue / Q000009:adverse effects*; D008875:Middle Aged; D010092:Oximetry / Q000009:adverse effects*; D010282:Parathyroid Neoplasms / Q000601:surgery; D016105:Parathyroidectomy / Q000009:adverse effects*; D011183:Postoperative Complications
chemical_list: D008751:Methylene Blue