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ANESTHETIC PHARMACOLOGY

Severe Anaphylactic Shock with Methylene Blue Instillation

Service d’anesthésie-réanimation chirurgicale, Hôpital Central CHU, Nancy, France

Address correspondence and reprint requests to Pascale Dewachter, MD, PhD, Service d’anesthésie-réanimation chirurgicale Hôpital Central CHU 29 Avenue du Maréchal de Lattre de Tassigny 54035 Nancy France. Address e-mail to pascale.dewachter{at}wanadoo.fr.

We report a documented severe immunoglobulin E-mediated hypersensitivity reaction associated with use of 1% methylene blue for detection of tubal permeability occurring during general anesthesia. Clinical symptoms, biological assessment results, and cutaneous test positivity confirmed an anaphylactic reaction to methylene blue. This case report confirms the need for systematic allergological investigation of all drugs and substances administered during the perioperative period in the event of a hypersensitivity reaction occurring during anesthesia. Anesthesiologists should be aware of the possibility of hypersensitivity reactions involving any drug or substance used during surgery.