Adverse reactions to patent blue V dye - The NEW START and ALMANAC experience

作者：Barthelmes L; Goyal A; Newcombe R G; McNeill F; Mansel R E^*

来源：European Journal of Surgical Oncology, 2010, 36(4): 399-403.

DOI：10.1016/j.ejso.2009.10.007

• Allergy
• Anaphylaxis
• Breast cancer
• Isosulfan blue
• Patent blue V
• Sentinel lymph node biopsy

Background: Blue dye with or without isotope has been widely used to identify the sentinel lymph node(s) in breast cancer. Patent blue V is used in the UK while its isomer isosulfan blue is used in the US. The allergic potential of isosulfan blue is well documented (1.4% adverse reactions) but that of patent blue V is less clearly defined.
Methods: In this paper we review the adverse reactions of patent blue V in 7,917 patients who participated in the NEW START training programme and the ALMANAC trial. All patients underwent sentinel lymph node biopsy for breast carcinoma using patent blue V in combination with (99m)Tc-albumin colloid.
Results: In total, 72 of 7,917 (0.9%) patients experienced adverse reactions'. non-allergic reactions were observed in 4 (0.05%) patients, 23 (0.3%) patients had minor grade I allergic skin reactions (urticaria, blue hives, pruritis, or generalised rash) and 16 (0.2%) had grade II reactions (transient hypotension/bronchospasm/laryngospasm). Severe Grade HI reactions (severe hypotension requiring vasopressor support and/or change/abandoning of planned procedure and/or HDU/ITU admission) were noted in 5 (0.06%) patients. The type of adverse reaction was not specified in 24 (0.3%) patients. No mortality was recorded.
Conclusion: The allergic potential of patent blue V dye compares favourably with isosulfan blue however both the surgeon and anaesthetist need to be alert to the risk of allergic reactions.

• 出版日期2010-4