Page 9 - World Journal of Laparoscopic Surgery

WJOLS
WJOL S

10.5005/jp-journals-10033-1302
Can Laparoscopic Chromopertubation with Methylene Blue Dye cause Anaphylactic Reactions like Pulmonary Edema?
RESEARCH ARTICLE

Can Laparoscopic Chromopertubation with Methylene

Blue Dye cause Anaphylactic Reactions like
Pulmonary Edema?

1 Rebecca Bagadia, Vishwa Kanabar
2

ABSTRACT of oxidation–reduction function and tissue staining. It
Diagnostic laparoscopy has been performed ever since inter­ has an opposite effect on hemoglobin depending upon its
ests in infertility and fertility have developed. Methylene blue concentration. In higher levels, methylene blue converts the
is administered to check tubal patency during the procedure. ferrous iron of reduced hemoglobin to the ferric form and
Extravasation of methylene blue is a recognized complication produces methemoglobin. Lower levels help in converting
of diagnostic laparoscopy and chromopertubation. Anaphy­
laxis and anaphylactic reactions in the perioperative period methemoglobin to hemoglobin in drug-induced methemo-
are a significant concern for surgeons and anesthesiologists. globinemia. Evaluation of tubal factor infertility is moving
The incidence is as high as 1 in 3,500 with a mortality rate of from mere anatomical assessment to morphological and
16
3 to 6%. There are no relevant literature or research article 4
that provides sufficient data or guidelines for determining the functional enquiry of the patency of the tubes. These days
nature of these reactions, mode of treatment algorithm, or the laparoscopy is being increasingly used in the evaluation
certain specifications we should consider before performing of infertility, especially laparoscopic chromopertubation
the procedure. This is a review literature for performing a safe with methylene blue, which has become the gold standard
practice evaluation and management.
for the functional assessment of the tubes.
Keywords: Allergy hypersensitivity, Anaphylaxis, Chromo­ Life-threatening anaphylactic or anaphylactoid
pertubation, Methylene blue, Perioperative, Pulmonary edema.
reactions to methylene blue have been reported in the
How to cite this article: Bagadia R, Kanabar V. Can Laparo­ literature; recently, methylene blue has been used for
5,6
scopic Chromopertubation with Methylene Blue Dye cause various conditions like sentinel node biopsy, but due to
Anaphylactic Reactions like Pulmonary Edema? World J Lap
Surg 2017;10(2):51­53. the rare reporting of its reactions, it was considered safest
among dyes.
Source of support: Nil
Conflict of interest: None AIMS AND OBJECTIVE

The aim of the study is to make the surgeons know the
INTRODUCTION
complications of methylene blue toxicity during the most
Anaphy-laxis and anaphylactic reactions in the peri- common procedure of laproscopic chromopertubation,
operative period are a significant concern for surgeons which most of us are unaware, and how to be careful
and anesthesiologists. and vigilant during the entire procedure.
The incidence is as high as 1 in 3,500 with a mortality
rate of 3 to 6%. 1 MATERIALS AND METHODS
Methylene blue is a new tool to evaluate in vivo tubal Literature review is performed using search terms that
damage, and is a simple method of estimating salpin- included methylene blue, chromopertubation pulmonary
2
geal function. Methylene blue is a common dye used in edema, anaphylaxis perioperative, and hypersensitivity.
diagnostic procedures for checking the patency of the Results were taken from recent case reports, basic
3
fallopian tubes. This compound has a unique property science literature, and clinical studies.
Searches in the literature on methylene blue toxicity
1 Consultant, Assistant Professor during laproscopy chromopertubation were conducted via
2
pubmed, google scholer, medline and chochrene liberary
1 Department of Obstetrics and Gynecology, Divine Life Hospital
Kutch, Gujarat, India database. No language restriction was applied to searches.
2 Department of Obstetrics and Gynecology, Government
Medical College, Bhavnagar, Gujarat, India RESULTS
Corresponding Author: Rebecca Bagadia, Consultant Although there have been slight variations in the inci-
Department of Obstetrics and Gynecology, Divine Life Hospital dences, management, evaluation, and their reporting,
Kutch, Gujarat, India, Phone: +918147723187, e­mail: bagadiap@ the authors do believe in the great saying “prevention is
yahoo.com
better than cure.”
World Journal of Laparoscopic Surgery, May-August 2017;10(2):51-53 51