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Lepor H, Wiegand L, Patel K, Du W, Gagnon S. A Randomized Clinical Trial Evaluating Indigo Carmine as a Visualization Aid for Evaluating Ureteral Patency. Urology 2024; 184:105-111. [PMID: 38061609 DOI: 10.1016/j.urology.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/17/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To determine whether intravenous indigo carmine provides a visualization advantage compared to saline in the evaluation of ureteral patency in a randomized, controlled clinical trial. METHODS Patients undergoing urological or gynecological surgical procedures in which the patency of the ureter was to be assessed received a saline injection and were randomized to receive 2.5 mL or 5.0 mL of indigo carmine. Blinded video assessments were conducted by independent reviewers using a conspicuity scale ranked 1 (poorest) to 5 (best), and subjects with scores ≥3 and at least a + 1-point difference from saline were considered responders. Time to visualization was recorded for indigo carmine. A responder analysis evaluated whether indigo carmine showed improved visualization. RESULTS There were 96 ureters evaluated with the 5.0 mL dose of indigo carmine, 92 with the 2.5 mL dose, and 180 with saline. Most ureters were scored a 4 or higher on the conspicuity scale following indigo carmine; both doses were significantly better than saline (P < .0001). Overall, 92.3% of patients were rated as a responder for either ureter. The median time to visualization of blue color was not significantly different (6.0 minutes in the 5.0 mL group and 5.9 minutes in the 2.5 mL group). There were no adverse events related to indigo carmine use. CONCLUSION Both dose levels of indigo carmine were significantly better than saline as a visualization aid for ureter patency.
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Affiliation(s)
- Herbert Lepor
- Department of Urology, New York University Grossman School of Medicine, New York, NY
| | - Lucas Wiegand
- Department of Urology, University of South Florida College of Medicine, Tampa, FL
| | | | - Wei Du
- Clinical Statistics Consulting, Blue Bell, PA
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Urologic Complication after Laparoscopic Hysterectomy in Gynecology Oncology: A Single-Center Analysis and Narrative Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121869. [PMID: 36557071 PMCID: PMC9782160 DOI: 10.3390/medicina58121869] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Minimally invasive surgery (MIS) has recently increased its application in the treatment of gynecological malignancies. Despite technological and surgical advances, urologic complications (UC) are still the main concern in gynecology surgery. Current literature reports a wide range of urinary tract injuries, and consistent scientific evidence is still lacking or dated. This study aims to report a large single-center experience of urinary complications during laparoscopic hysterectomy for gynecologic oncologic disease. Materials and Methods: All patients who underwent laparoscopic hysterectomy for gynecologic malignancy at the Department of Medicine and Surgery of the University Hospital of Parma from 2017 to 2021 were retrospectively included. Women with endometrial cancer, cervical cancer, ovarian cancer, uterine sarcoma, or borderline ovarian tumors were included. Patients undergoing robotic surgery with incomplete anatomopathological data or patients lost during follow-up were excluded from the analysis. Intraoperative and postoperative UC were analyzed and ranked according to the Clavien-Dindo classification. Results: Two hundred-sixty patients were included in the study: 180 endometrial cancer, 18 cervical cancer, nine ovarian cancer, two uterine sarcomas, and 60 borderline ovarian tumors. Nine (3.5%) UCs were reported (five intraoperative and four postoperative complications). No anamnestic variables showed a statistical correlation with the surgical complication in the univariable analyses. C1 radical hysterectomy, a higher FIGO stage, and postoperative adjuvant treatment (p-value = 0.001, p-value = 0.046, and p-value = 0.046, respectively) were independent risk factors associated with the occurrence of UC. Conclusions: The urological complication rates in patients with oncological disease are relatively rare events in the expert hands of dedicated surgeons. Radical hysterectomy, FIGO stage, and adjuvant treatment are independent factors associated with urinary complications.
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Asaga S, Tsuchiya A, Ishizaka Y, Miyamoto K, Ito H, Isaka H, Chiba T, Imoto S, Kamma H. Long-term results of fluorescence and indigo carmine blue dye-navigated sentinel lymph node biopsy. Int J Clin Oncol 2021; 26:1461-1468. [PMID: 33877488 DOI: 10.1007/s10147-021-01925-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 04/13/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sentinel lymph node biopsy is widely applied for the management of clinically node-negative breast cancer, and a radioisotope with a blue dye are most often used as tracers. Fluorescence of indocyanine green could also potentially be used as tracer. This study aimed to demonstrate the long-term survival results of fluorescence-guided sentinel lymph node biopsy. PATIENTS AND METHODS Patients with clinically node-negative breast cancer who underwent surgery as initial treatment were included in this study. Both fluorescence of indocyanine green and indigo carmine blue dye were used as tracers. Axillary lymph node dissection was omitted unless metastasis was pathologically proven in sentinel nodes. Breast cancer recurrence and death were recorded and prognostic factors were identified using disease-free survival and overall survival data. RESULTS A total of 565 patients were analyzed. There were 14 (2.5%) patients whose sentinel nodes could not be identified, yielding an identification rate of 97.5%. Axillary dissection was performed in 90 patients. Forty-three recurrences including 6 ipsilateral axilla recurrence and 13 deaths were observed during the median 83 months of follow-up period. Seven-year disease-free and overall survival were 92.4% and 97.3%, respectively. Multivariate analyses demonstrated that pre-menopausal status and invasive lobular carcinoma were significant unfavorable prognostic factors of disease-free survival. Half of ipsilateral axilla recurrences occurred within 5 years after surgery and these recurrences were correlated with inappropriate adjuvant therapy. CONCLUSION Fluorescence-guided sentinel lymph node biopsy demonstrated favorable prognostic results and could be alternative to the radioisotope for clinically node-negative breast cancer.
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Affiliation(s)
- Sota Asaga
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Ai Tsuchiya
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Yoshiharu Ishizaka
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Kaisuke Miyamoto
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hiroki Ito
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan.,Department of Breast Surgery, Kaneko Clinic, 8-6 Uearata-cho, Kagoshima, Kagoshima, 890-0055, Japan
| | - Hirotsugu Isaka
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Tomohiro Chiba
- Department of Pathology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan.,Department of Pathology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto Ward, Tokyo, 135-8550, Japan
| | - Shigeru Imoto
- Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hiroshi Kamma
- Department of Pathology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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Dextrose Instillation as an Alternative Agent to Observe Ureteral Efflux During Pelvic Reconstructive Surgery. Urology 2018; 120:74-79. [PMID: 29958966 DOI: 10.1016/j.urology.2018.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/04/2018] [Accepted: 05/16/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the use, cost, postoperative urinary tract infection (UTI) rates, and complications of dextrose instillation during cystoscopy. METHODS The medical records of patients who underwent cystoscopy during pelvic reconstructive surgery between June 2016 and June 2017 were reviewed. Patients were divided into two groups: patients who had one ampule of dextrose 50% (D50) directly instilled and patients who did not have D50 instilled during cystoscopy. Preoperative demographics, UTI rates, and postoperative complications were compared. Pharmaceutical cost and availability were reported by the pharmacy at our institution. RESULTS Out of 63 patients identified, dextrose instillation was used in 20 patients and no dextrose was used in 43 patients. Each ampule of D50 cost $2.18 and there were no problems with supply shortage. As D50 was directly instilled into the bladder, there was immediate visualization of ureteral efflux at the time of surgery. Three patients (15%) in the dextrose group and 10 patients (23%) in the nondextrose group developed postoperative UTIs. There was no statistically significant difference in postoperative UTI rates between the two groups (p = 0.43) and there were no differences in postoperative complications. CONCLUSION Dextrose is a safe, cost-effective, readily available agent that provides instantaneous visualization of ureteral efflux without an increased risk of postoperative UTI.
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Anaphylactic Shock After Intravenous Fluorescein Administration for Intraoperative Cystoscopy. Obstet Gynecol 2018. [DOI: 10.1097/aog.0000000000002519] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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6
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Chromophores in operative surgery: Current practice and rationalized development. J Control Release 2017; 249:123-130. [DOI: 10.1016/j.jconrel.2016.12.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/23/2016] [Accepted: 12/28/2016] [Indexed: 12/18/2022]
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Luketic L, Murji A. Options to Evaluate Ureter Patency at Cystoscopy in a World Without Indigo Carmine. J Minim Invasive Gynecol 2016; 23:878-85. [DOI: 10.1016/j.jmig.2016.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/10/2016] [Accepted: 06/10/2016] [Indexed: 12/15/2022]
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Electromagnetic Navigation Bronchoscopy–directed Pleural Tattoo to Aid Surgical Resection of Peripheral Pulmonary Lesions. J Bronchology Interv Pulmonol 2016; 23:245-50. [DOI: 10.1097/lbr.0000000000000214] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Narasimhulu DM, Prabakar C, Tang N, Bral P. 50% dextrose versus normal saline as distension media during cystoscopy for assessment of ureteric patency. Eur J Obstet Gynecol Reprod Biol 2016; 199:38-41. [PMID: 26896595 DOI: 10.1016/j.ejogrb.2016.01.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/05/2016] [Accepted: 01/29/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare the visualization of ureteric jets when using 50% dextrose (D50) as opposed to normal saline (NS) as distension media during cystoscopy. STUDY DESIGN Cross sectional study. METHODS Two patients each had two cystoscopy videos recorded at the time of a ureteric jet; one using NS and the other using D50 resulting in two sets of paired videos (four videos). A fifth cystoscopy video was recorded, as a control, at a time when there was no ureteric-jet. Fifty participants including attending physicians, residents and medical students were recruited at an academic-affiliated community hospital. Participants were blinded to the medium used and viewed each of the five videos. Participants assessed each video for presence of a ureteric-jet, ease of interpretation, and compared the paired D50 and NS videos for clarity of ureteric-jets. MAIN OUTCOME MEASURES Participant's assessment of clarity of the ureteric jets when D50 was used as compared to when NS was used in the paired videos. RESULTS All 100 observations of the two D50 videos with jets identified the presence of a jet; for the NS videos, 96/100 observations identified a jet, 2/100 did not identify a jet and 2/100 were unsure. 48/50 observations of the video with no jet were correct, while 2/50 were unsure. Participants rated the ureteric-jets to be clearer in videos with D50 (86% vs 14%, P<0.001); and had difficulty interpreting cystoscopy videos with NS (62% vs 2%, OR: 80, 95% CI: 10.2-627.6). CONCLUSION Participants preferred the clarity of the ureteric-jet when 50% dextrose was used as the distension medium during cystoscopy as compared to normal saline.
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Affiliation(s)
| | - Cheruba Prabakar
- Department of Obstetrics and Gynecology, Maimonides Medical Center, United States
| | - Nancy Tang
- Department of Obstetrics and Gynecology, Maimonides Medical Center, United States
| | - Pedram Bral
- Department of Obstetrics and Gynecology, Maimonides Medical Center, United States
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Sutton E, Pietrzak A. Indigo Carmine-Induced Hypotension in a Parturient With Idiopathic Pulmonary Artery Hypertension, Hypertrophic Cardiomyopathy, and LAD Myocardial Bridging. J Cardiothorac Vasc Anesth 2015; 30:158-61. [PMID: 26006159 DOI: 10.1053/j.jvca.2015.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Evan Sutton
- Loyola University Medical Center, Maywood, IL.
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Higashimori A, Yokoi Y. Use of indigo carmine angiography to qualitatively assess adequate distal perfusion after endovascular revascularization in critical limb ischemia. J Endovasc Ther 2015; 22:352-5. [PMID: 25887729 DOI: 10.1177/1526602815582208] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report a novel technique to visualize the efficacy of revascularization in critical limb ischemia patients with ischemic foot ulcers. TECHNIQUE An 80-year-old man was admitted with nonhealing ulcers on his left second toe and lateral border of the foot owing to in-stent restenosis of the left popliteal artery. After dilation of the popliteal in-stent restenosis, below-the-knee angiography revealed that the anterior tibial artery (ATA) was occluded, the posterior tibial artery was hypoplastic, and the peroneal artery was enlarged, with 2 plantar arteries. To evaluate the foot circulation before performing additional procedures, a 4-F multipurpose catheter was advanced into the peroneal artery, and 5 mL of indigo carmine was injected. Immediately, the patient's second toe and lateral border ulcers were dyed blue. We concluded that sufficient blood flow had been obtained to the ulcerated area by balloon angioplasty alone, so the procedure was terminated. The ulcers completely healed at 1 month. CONCLUSION Indigo carmine angiography provides visual information on foot perfusion, yielding new insights into microcirculation and helping to determine the effectiveness of treatment and procedure endpoint.
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Affiliation(s)
| | - Yoshiaki Yokoi
- Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan
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12
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Brockow K, Sánchez-Borges M. Hypersensitivity to contrast media and dyes. Immunol Allergy Clin North Am 2015; 34:547-64, viii. [PMID: 25017677 DOI: 10.1016/j.iac.2014.04.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This article updates current knowledge on hypersensitivity reactions to diagnostic contrast media and dyes. After application of a single iodinated radiocontrast medium (RCM), gadolinium-based contrast medium, fluorescein, or a blue dye, a hypersensitivity reaction is not a common finding; however, because of the high and still increasing frequency of those procedures, patients who have experienced severe reactions are nevertheless frequently encountered in allergy departments. Evidence on allergologic testing and management is best for iodinated RCM, limited for blue dyes, and insufficient for fluorescein. Skin tests can be helpful in the diagnosis of patients with hypersensitivity reactions to these compounds.
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Affiliation(s)
- Knut Brockow
- Department of Dermatology and Allergy Biederstein, Technische Universität München, Biedersteiner Strasse 29, Munich 80802, Germany.
| | - Mario Sánchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Clínica El Avila, 6a transversal de Altamira, piso 8, consultorio 803, Caracas 1060, Venezuela
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Adekola H, Gill N, Sakr S, Hobson D, Bryant D, Abramowicz JS, Soto E. Outcomes following intra-amniotic instillation with indigo carmine to diagnose prelabor rupture of membranes in singleton pregnancies: a single center experience. J Matern Fetal Neonatal Med 2015; 29:544-9. [DOI: 10.3109/14767058.2015.1015982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Henry Adekola
- Division of Maternal–Fetal Medicine, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA,
| | - Navleen Gill
- Department of Obstetrics and Gynecology, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA, and
| | - Sharif Sakr
- Department of Obstetrics and Gynecology, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA, and
| | - Deslyn Hobson
- Department of Obstetrics and Gynecology, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA, and
| | - David Bryant
- Division of Maternal–Fetal Medicine, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA,
| | - Jacques S. Abramowicz
- Division of Maternal–Fetal Medicine, Hutzel Women's Hospital, Detroit Medical Center, Wayne State University, Detroit, MI, USA,
| | - Eleazar Soto
- Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Abstract
For centuries, food additives have been used for flavouring, colouring and extension of the useful shelf life of food, as well as the promotion of food safety. During the last 20 years, the studies implicating the additives contained in foods and medicine as a causative factor of allergic reactions have been proliferated considerably. In this review, we aimed to overview all of the food additives which were approved to consume in EU and find out how common and serious allergic reactions come into existence following the consuming of food additives.
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Affiliation(s)
- Fatih Gultekin
- Medical Biochemistry Department, Medical Faculty, Suleyman Demirel University, Cunur, Isparta, Turkey.
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Kim SH, Suk EH, Kil SH, Hahm KD, Hwang JH. Hypotension in patients administered indigo carmine containing impurities -A case report-. Korean J Anesthesiol 2011; 61:435-8. [PMID: 22148095 PMCID: PMC3229025 DOI: 10.4097/kjae.2011.61.5.435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 03/16/2011] [Accepted: 03/21/2011] [Indexed: 11/26/2022] Open
Abstract
Indigo carmine has been used for eight decades with few adverse effects. Several of our patients, however, experienced severe hypotensive episodes after indigo carmine administration within a period of one month. Analysis of the raw materials used to formulate the preparation of indigo carmine we used showed that they contained impurities. Following recall of these impure materials, none of our patients experienced further hypotensive episodes.
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Affiliation(s)
- Sung-Hoon Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Abstract
Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anaesthesiologist, and subsequent determination of the responsible agent(s) with strict avoidance of subsequent administration of all incriminated and/or cross-reacting compounds. However, correct identification of the causative compound(s) and safe alternatives is not always straightforward and, too often, not done. This review is not intended to discuss acute management of anaesthesia-related anaphylaxis but summarizes the major causes of anaphylaxis during anaesthesia and the diagnostic approach of this rare but potentially life-threatening complication. Apart from general principles about the diagnostic approach, history taking and importance of tryptase quantification, more specific confirmatory diagnostic procedures are organized on the basis of the major causes of perioperative anaphylactic reactions.
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Affiliation(s)
- D G Ebo
- Department of Immunology, Allergology and Rheumatology, University of Antwerp, Antwerpen, Belgium
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Song JG, Eom W, Jeong H, Cho D, Shin HY. Pulseless Electrical Activity of Unknown Origin during Total Gastrectomy - A case report -. Korean J Anesthesiol 2007. [DOI: 10.4097/kjae.2007.53.2.246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jae Gyok Song
- Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Korea
| | - Woosik Eom
- Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Korea
| | - Haejeong Jeong
- Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Korea
| | - Daesoon Cho
- Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Korea
| | - Hye-young Shin
- Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea
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Graziano S, Hoyte L, Vilich F, Brubaker L. Life-threatening reaction to indigo carmine--a sulfa allergy? Int Urogynecol J 2005; 16:418-9. [PMID: 16027953 DOI: 10.1007/s00192-005-1323-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2004] [Accepted: 05/03/2005] [Indexed: 11/30/2022]
Abstract
Indigo carmine is commonly used during cystoscopy when evaluating for lower urinary tract safety after gynecologic surgery. We report a case of severe hypotension and bradycardia following intravenous indigo carmine injection in a patient with known sulfa allergy.
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Affiliation(s)
- Scott Graziano
- Department of Obstetrics and Gynecology Department of Anesthesiology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA.
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Reply to I. Esinler. Eur Urol 2004. [DOI: 10.1016/j.eururo.2004.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
There are considerable variations in the size and the origin of internal carotid arteries (ICAs) of New Zealand white rabbits. A simple test that could correctly identify the ICA could facilitate intracarotid delivery of drugs and embolic material for research in these animals. Five conventional methods for identifying the ICA proved inferior to a novel retinal discoloration test (RDT). A positive RDT implies a change in color of the retinal reflex after injection of 0.2 mL of indigo-carmine blue (ICB). We conclude that RDT is a useful test for correctly identifying and isolating the ICA in this animal species.
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Affiliation(s)
- Shailendra Joshi
- Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA.
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