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Characterization of the Rapid Drop in Pulse Oximetry Reading After Intraoperative Administration of Methylene Blue in Open Thoracoabdominal Aortic Repairs

Rong, Lisa Q. MD*; Mauer, Elizabeth MS*; Mustapich, Taylor L. BA*; White, Robert S. MD*; Di Franco, Antonino MD; Girardi, Leonard N. MD; Gaudino, Mario MD; Pryor, Kane O. MD*

doi: 10.1213/ANE.0000000000004325
Cardiovascular and Thoracic Anesthesiology
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This study evaluates the changes of oxygen saturation (Spo2) after intravenous administration of methylene blue in 103 patients undergoing open repair of thoracoabdominal aortic aneurysms. We found that Spo2 decreased by a median (interquartile range [IQR]) of 49% (37%–81%) <1 minute after methylene blue administration and recovered completely after approximately 6 minutes—median (IQR) of 270 seconds (180–510). A shorter time to nadir Spo2 was associated with a higher nadir (Spearman r [95% confidence interval {CI}], −0.32 [−0.50 to −0.13]; P = .001). Body surface area (BSA) was positively correlated with nadir Spo2 (Spearman r [95% CI], 0.36 [0.15–0.51]; P < .001).

From the Departments of *Anesthesiology

Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York.

Published ahead of print 4 May 2019.

Accepted for publication April 5, 2019.

Funding: None.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Lisa Q. Rong, MD, Department of Anesthesiology, Weill Cornell Medicine, 525 E 68th St, M324, New York, NY. Address e-mail to lir9065@med.cornell.edu.

Copyright © 2019 International Anesthesia Research Society
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