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Are There Differences?

Antonio Piñero, MD, PhD; Julián Illana, MD, PhD; Carlos García-Palenciano, MD; Francisco Cañizares, MD; Manuel Canteras, PhD; Victoria Cañadillas, MD; Eugenia Durán, MD; Pascual Parrilla, MD, PhD

Arch Surg. 2004;139:1204-1207.

Hypothesis  There are differences between readings of peripheral blood oxygen saturation when the effect on saturation values of methylene blue is compared with that of isosulfan blue when used in sentinel lymph node biopsy in patients with breast cancer.

Design  Prospective randomized study.

Setting  University tertiary care center.

Patients  Thirty-two women undergoing surgery for breast cancer using sentinel lymph node biopsy.

Interventions  Sentinel lymph node biopsy usingmethylene blue (16 patients) and isosulfan blue (16 patients); there was also a control group of 6 surgicalpatients in whom dyes were not used.

Main Outcome Measures  Peripheral saturation of blood using pulse oximetry, oxygen saturation by blood-gas analysis, partial oxygen pressure by blood-gas analysis, and plasma dye levels, recorded before dye injection and 15, 30, and 60 minutes afterward.

Results  The 2 dyes interfered with the peripheral saturation reading, but only isosulfan blue showed significant differences. The differences in blood-gas analysis values between the 2 groups and with regard to the controls were not significant.

Conclusions  Methylene blue interferes less than isosulfan blue in the peripheral saturation reading. Desaturation is factitious in both cases, and does not correspond to alterations in blood-gas analysis values.

Author Affiliations: Departments of General Surgery (Drs Piñero, Illana, and Parrilla), Anaesthesia (Drs García-Palenciano, Cañadillas, and Durán), and Clinical Analysis (Dr Cañizares), "Virgen de la Arrixaca" University Hospital; and Department of Biostatistics, School of Medicine (Dr Canteras), Murcia, Spain.
Accepted for Publication: May 31, 2004.

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