Surgical Dye Triggered Rare Oxygen Blood Condition
A patient developed methemoglobinemia and blue skin after receiving a routine dye injection during reconstruction surgery.
Updated on Sept. 28, 2026 in Heart Disease
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In a July 2025 report, clinicians documented a 60-year-old patient who developed bluish skin and blue-green urine following a 50-mg injection of Patent Blue V. The patient also experienced a mild drop in blood oxygen readings on pulse oximetry, a known side effect of the diagnostic dye used in surgery.
Why it matters
Methemoglobinemia can complicate surgical monitoring because it prevents hemoglobin from effectively binding oxygen and can cause pulse oximeters to register falsely low readings. This condition underscores the importance of clinical vigilance when using common surgical dyes to stain lymphatic vessels.
This case report published in A&A Practice details a 60-year-old patient who developed methemoglobinemia after a 50-mg dose of Patent Blue V. The findings are preliminary, representing a single clinical observation.
The players
A&A Practice
A peer-reviewed journal publishing research on clinical anesthesia and surgical practices.
The details
Patent Blue V is used to highlight lymphatic vessels and nodes for identification during surgery. When injected, the dye can trigger methemoglobinemia, a state where the iron in hemoglobin is oxidized, rendering it unable to bind oxygen properly. Because pulse oximeters estimate oxygen saturation by shining light through the skin, the presence of this dye can lead to inaccurate, falsely low readings.
Timeline
July 2025: Case report published in A&A Practice.
24 to 48 hours: Typical duration for the body to clear Patent Blue V through urine.
Health Landscape
Surgical staining remains a standard diagnostic tool, though clinicians continue to monitor for rare adverse reactions like methemoglobinemia. This report joins previous observations from Turkey, Melbourne, and Germany in the ongoing documentation of rare patient responses to surgical dyes.
If you are scheduled for surgery requiring lymphatic mapping, consider discussing known side effects of surgical dyes with your surgical team. Be aware that transient skin discoloration or fluctuations in pulse oximetry readings may occur, and these findings are worth discussing with your doctor if they persist.
The takeaway
While Patent Blue V is a helpful tool for surgical identification, it can temporarily affect oxygen monitoring and skin color. Readers undergoing procedures should ask their surgical team about the use of diagnostic dyes and how their oxygen levels will be monitored.
Further reading
For more information on diagnostic procedures, see our Heart Disease section.
Source note: This article includes information reported by Medical Daily.
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