The first is for vasoplegic syndrome, a type of distributive shock that occurs during coronary procedures specifically coronary artery bypass graftingas a means to increase systemic vascular resistance when the use of epinephrine is refractory. In turn, this will increase the oxygen-binding capacity of hemoglobin and thus increase oxygen delivery to tissues.

This property is also exhibited by vitamin C, which is an alternative treatment option for methemoglobinemia. One of the most common adverse effects of methylene blue is the bluish-green discoloration of urine.

Another common adverse effect is limb pain following IV administration. Methylene blue is contraindicated due to any hypersensitivities or anaphylaxis after past administration and for those with glucosephosphate dehydrogenase deficiency due to susceptibility of experiencing hemolytic anemia. Those experiencing hemolytic anemia under this situation will have jaundice and characteristic Heinz bodies on a peripheral blood smear. The research concludes that there has been no antidote for treating methylene blue toxicity to be found to exist.

If anaphylaxis does occur, the administration of methylene blue should stop immediately and promptly follow by supportive care, although severe anaphylactic shock with methylene blue is quite rare.

Methylene blue may become potentially fatal when used in combination with medications, which include or increase serotonin; this is because of its monoamine oxidase inhibiting properties.

Understanding and mastering the indications for the use of methylene blue is essential in many potentially life-threatening situations such as vasoplegic syndrome and ifosfamide-induced encephalopathy, that if not acted upon appropriately and promptly, these disorders could spell disaster for the patient. The entire interprofessional healthcare team must maintain open communication and information sharing to optimize the use of methylene blue for maximum patient benefit.

Health Benefits and Risks of Methylene Blue in Medicine

Take Free Questions on this Article. Methylene Blue. Adverse Effects One of the most common adverse effects of methylene blue is the bluish-green discoloration of urine. Contraindications Methylene blue is contraindicated due to any hypersensitivities or anaphylaxis after past administration and for those with glucosephosphate dehydrogenase deficiency due to susceptibility of experiencing hemolytic anemia.

Toxicity The research concludes that there has been no antidote for treating methylene blue toxicity to be found to exist. Revista brasileira de anestesiologia. Journal of anaesthesiology, clinical pharmacology. PloS one. Journal of clinical anesthesia. British journal of cancer. British medical journal. Frontiers in immunology. Lancet London, England. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

The Annals of thoracic surgery. Malaria journal. Journal of psychopharmacology Oxford, England. Archives of disease in childhood. American journal of therapeutics. Prenatal diagnosis. Dudley NE, Methylene blue for rapid identification of the parathyroids. Shanmugam G, Vasoplegic syndrome--the role of methylene blue. Gillman PK, CNS toxicity involving methylene blue: the exemplar for understanding and predicting drug interactions that precipitate serotonin toxicity.

Cragan JD, Teratogen update: methylene blue.Methylene blue, a commonly used stain employed to enhance tissue specimens viewed under a microscope, also has wide ranging medical applications.

In addition to dying tissue during diagnostic and surgical procedures, this substance also acts as an antidote for cyanide poisoning.

As a medication, methylene blue can be taken orally or intravenously. Both potassium cyanide and carbon monoxide poisoning have been treated using methylene blue as an antidote. It was first used for cyanide poisoning during the s and was employed during the midth century to treat carbon monoxide exposure.

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Still used to counter cyanide poisoning, hyperbaric oxygen has replaced it as the preferred method of treating carbon monoxide exposure. Another historic use of the drug is for the treatment of malaria; there is a renewed interest in using it for this purpose due to its cost effectiveness. Methemoglobinemia is an excess of methemoglobin in the blood.

methylene blue uses in surgery

Unlike hemoglobinmethemoglobin cannot carry vital oxygen to the cells and tissues of the body, causing the characteristic pale or bluish skin associated with this disorder. This condition may be congenital or induced by an exposure to certain chemicals.

Infants are particularly susceptible to acquired methemoglobinemia when exposed to excessive levels of nitrates in water caused by agricultural runoff. Methylene blue is generally given intravenously to treat acquired methemoglobinemia, while oral doses are given for the congenital type of the disease.

Methylene blue also acts as a monoamine oxidase inhibitor MAOI and is used in the treatment of depression and anxiety.

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Serious side effects can occur if this medication is used with selective serotonin reuptake inhibitors SSRIs. It is also used in the manufacture of antipsychotic medications prescribed to treat schizophrenia and other disorders. Research continues on its use with Alzheimer's and Parkinson's diseases.

In conjunction with antibiotics, methylene blue is administered orally to treat urinary tract infections. The blue dye is also used in diagnostic and surgical procedures of the bladder and other tissues and organs. It aids medical procedures by enhancing the tissues, making them easier to view.

Methylene Blue – 101 uses

Methylene blue is used during laparoscopic, endoscopic and x-ray procedures. Studies continue researching the roles this medication might play in cancer treatment. It is used to help map lymph nodes in cases of breast cancer and is effectively used to treat neurotoxicity caused by the chemotherapy agent ifosfamide.

As a direct treatment for cancer, methylene blue has been shown induce cancer cell apoptosis. Its use in conjunction with light is also being studied for treatment of cancer and other diseases. Both might turn blue-green in color, which ceases after the medication is discontinued.

Other side effects include nausea, vomiting and diarrhea.

What Are the Medical Uses of Methylene Blue?

Rare side effects include fainting, excessive tiredness and irregular heartbeat. Bargar Last Modified Date: December 19, Please enter the following code:. Login: Forgot password?OK, maybe not uses, but more than I had been previously aware of. I was idly watching CCM-L e-mails drift past me and on into the Deleted folder, when a thread caught my attention.

One of the regular participants wanted information on the use of Methylene Blue for refractory vasoplegia following on-pump cardiac surgery. The evidence for its benefit is limited, but here are some trials that were posted to the group to support its use Thanks to Flavio Nacul, an intensivist practicing in Rio de Janeiro :.

Just remember to check for G6PD deficiency It can precipitate a haemolytic crisis and severe renal failure before turning it on. Toggle navigation. Methylene Blue — uses Home Methylene Blue — uses. Reversal of severe vasoplegia with single-dose methylene blue after heart transplantation. J Thorac Cardiovasc Surg ;—4. Pagni S, Austin EH. Use of intravenous methylene blue for the treatment of refractory hypotension after cardiopulmonary bypass.

J Thorac Cardiovasc Surg ;—8. It is used in prophylaxis and therapy for ifosamide neurotoxicity Br J Cancer. Share this. Forgot your details? Create Account.The dye has been used in medicine for more than years for a variety of things — from staining bodily tissue during surgery to killing bacteria in urinary tract infections.

It works by destroying disease-causing free radicals.

methylene blue uses in surgery

And now scientists at the University of Maryland have found another use: anti-ageing. The researchers tested it for four weeks in skin cells from healthy middle-aged donors and octogenarians as well as patients diagnosed with progeria — a rare genetic disease that ages them quickly. Fibroblasts — skin cells that produce the structural protein collagen — experienced a decrease in damaging reactive oxygen species, a reduced rate of death and an increase in the rate of cell division throughout the treatment.

Anything that helps maintain collagen levels in the skin will keep it looking younger as natural levels of start to fall in your mids. By the age of 55 they may have fallen by 40 percent. Less collagen means skin that sags and wrinkles.

Methylene blue appears to make fundamental, long-term changes to skin cells. Please follow and like us:. Gut Feeling: Sensory cells of the mouse intestine let the brain know if certain compounds are present by speaking directly to gut neurons via serotonin.Linda Crampton is a writer and teacher with a first-class honors degree in biology.

She often writes about the scientific basis of disease. Methylene blue is a dark green powder with important medical and biological uses. It's a popular stain in biology labs because it makes the nucleus of a cell visible. It's also used as a dye in medical tests and during surgery because it colors body fluids and tissues, making them easy to see. Methylene blue is a medicine as well as a dye. It was the first synthetic drug to be created and was originally used as a malaria treatment.

CRRT Methylene Blue Prismaflex Green Effluent

Today it's used to treat a blood disorder called methemoglobinemia and neural problems that may result from treatment by ifosfamide, a chemotherapy drug. In addition, methylene blue is a weak antiseptic and helps to treat urinary tract infections. Research suggests that it may also be a useful medication for other health problems. In certain situations it can be harmful, however. This is methylene blue powder. On the right, the green powder has dissolved in water drops and become a blue solution.

Methylene blue powder is green in color. It actually exists as methylene blue chloride or more technically, methylthioninium chloride. When this compound is added to water, it breaks up into the positive methylene blue ion, which has a blue color, and the negative chloride ion, which is colorless.

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The positive methylene blue ions are attracted to negative particles, such as the nucleic acids DNA and RNA in the nuclei of cells. They bind to the nucleic acids and stain them blue, making them more visible than their background. Calvero, via Wikimedia Commons, public domain image. Methylene blue solutions range from light blue to dark blue in color, depending on their concentration.

Concentration is an important topic when considering the chemical, not only with respect to its ability to act as a biological stain but also with respect to its safety as a medicine. Methylene blue's ability to color parts of cells is helpful in certain medical tests. The dye gives doctors an improved view of body tissues.

Fortunately, doctors are generally aware of the fact that when the chemical is placed in the body as a dye it might have other effects in certain situations. New methylene blue and methyl blue are also biological stains.

They are not the same chemical as methylene blue, despite their similar names. Methylene blue treats health problems as well as acting as a dye.

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For example, it's very useful for clearing excess methemoglobin from a person's bloodstream. Methemoglobin is a chemically altered form of hemoglobin, the red pigment in our blood that transports oxygen from the lungs to our cells. An excessive amount of methemoglobin in the blood has serious consequences. Unlike normal hemoglobin, the altered form can't transport oxygen effectively. Our cells can't survive without the oxygen supplied by hemoglobin.

Methemoglobinemia is a potentially dangerous disorder in which the blood contains a higher amount of methemoglobin than normal. The condition may be inherited, but it's more often acquired during life.

Taking certain medications and eating too many foods containing nitrates or nitrites can cause the disorder.Methylene blue MB has been found to have unique analgesic property through temporary disruption of sensory nerve conduction. In anorectal surgery, MB is widely used as a biologic stain but the analgesic effect has never been studied. Thus, a literature review completed with critical appraisal is required to find out its efficacy.

A review has been run to find out its efficacy. There were articles in full text found, and four studies met the inclusion criteria. Two studies were focused on the evaluation of VAS in hemorrhoid surgery whereas the rest were focused on the evaluation of symptom score in anal pruritus. A study with level of evidence 2 on VAS showed the efficacy.

The rest showed insufficient evidence due to variations of anorectal surgery and the methods and techniques of MB application. A further prospective clinical study is required. Nowadays, methylene blue MB is widely used as biologic stain. In anorectal surgery, the use of high concentrated topical MB is not only staining the tip and nerve fibers, but also disrupting their function temporarily.

To this knowledge, MB has been used in the treatment of neuritis, to reduce pruritus and analgesia in anorectal surgery [ 1 — 3 ]. Pain and itch receptors are nerve endings that are not myelinated, located in the papillary layer of the skin with the highest numbers being in the epidermis and dermis. When this receptor is stimulated, excitatory neurons transmitted impulses to the dorsal horn of spinal cord and then continued to central nervous system to create pain or itch sensation [ 3 — 5 ].

This mechanism explains the efficacy of MB to reduce pain and itch. Subjects with perianal fistula where the tract is injected with MB will have lower postoperative pain compared to those who were not injected with it [ 6 ]. Studies in Singapore and China showed that perianal intradermal injection of MB provides temporary pain relief after hemorrhoidectomy and lateral anal sphincterotomy [ 16 — 8 ]. Other studies showed that subjects with severe anal pruritus intractable anal pruritus who were injected with MB intradermally had better symptom score [ 910 ].

However, published information of the efficacy in anorectal surgery remains unclear. Thus, a literature review was run, aimed at finding out its efficacy.Methylene blue may cause serious or fatal serotonergic syndrome when used in combination with serotonergic drugs.

Avoid concomitant use of methylene blue with selective serotonin reuptake inhibitors SSRIsserotonin and norepinephrine reuptake inhibitors SNRIsand monoamine oxidase inhibitors. Medically reviewed by Drugs. Last updated on Nov 18, Methylene blue injection is used to treat a condition called methemoglobinemia. This condition occurs when the blood cannot deliver oxygen where it is needed in the body. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do.

This is a decision you and your doctor will make. For methylene blue, the following should be considered:. Tell your doctor if you have ever had any unusual or allergic reaction to methylene blue or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of methylene blue injection in the elderly.

However, elderly patients are more likely to have kidney problems, which may require caution and an adjustment in the dose for patients receiving methylene blue. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.

When you are receiving methylene blue, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using methylene blue with any of the following medicines is not recommended.

Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

methylene blue uses in surgery

Using methylene blue with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Using methylene blue with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you.


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