• Tatsuo Kadoya, Yuki Kinoshita, Munehiro Shiraishi, Hirofumi Uehara, Toshinori Yamamoto, and Keiko Suetsugu.
• Masui. 2014 Aug 1; 63 (8): 862-5.

BackgroundIntraoperative staining of the parathyroid glands with intravenously administered methylene blue is well described and has been demonstrated as an effective and safe method to facilitate parathyroidectomy. However, there have been several literatures of the development of postoperative neurological toxicity in patients who received methylene blue infusion during parathyroidectomy. We report the method of methylene blue infusion during parathyroidectomy at our institution.MethodsSeven adult patients who had undergone parathyroidectomy for secondary hyperparathyroidism associated with chronic renal failure were included in this study. Methylene blue was administered at a constant rate of 4 mg x kg(-1) x hr(-1) with a 1% solution just before the start of operation. The infusion was stopped after the first parathyroid gland was identified.ResultsThe mean dose of methylene blue used was 2.2 +/- 0.8 mg x kg(-1). Consequently, the dose of methylene blue by this method could be decreased to less than half of the previously administered dose (6 mg x kg(-1)) at our institution.ConclusionsThe dose of methylene blue used should be kept to the minimum required to identify the parathyroid glands in each case.

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