Severe decrease in SpO2 and methemoglobinemia following subareolar isosulfan blue administration and clinical relevance

Özet

The level of axillary lymph node involvement in breast cancer is a critical decision factor for adjuvant therapy andthe most important indicator of prognosis and survival. Sentinel lymph node biopsy is a minimally invasive techniquewith low morbidity in axillary staging of breast cancer. Radiocolloid substances (Technetium-99m) and/or bluedyes such as methylene blue or isosulfan blue are used during sentinel lymph node biopsy. Isosulfan blue stain isfrequently used in sentinel lymph node biopsy and rarely causes complications. The present case report presentsa severe decrease in SpO2 due to methemoglobinemia following isosulfan blue administration as well as skin andurine signs and inconsistency with clinical picture in a 67-year-old, 77 kg, ASA II female case who underwent sentinellymph node biopsy under general anesthesia.