Der Anaesthesist
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Patent blue V is widely used as a food dye. Clinically, patent blue V dye has been increasingly used in oncological surgery to identify the sentinel lymph nodes in breast cancer and other malignancies. The case of a patient who developed severe anaphylactic shock to subcutaneous injection of patent blue V during breast surgery is presented. The clinical course and the anesthesiological management are presented, and the pitfalls that may delay the correct diagnosis are highlighted.
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The case of a female patient is reported where difficulty in securing the airway occurred during a reconstructive intervention following partial mandibular resection. During previous surgery the last of which was 2 months prior to this, endotracheal intubation was carried out with the GlideScope videolaryngoscope, but now the vocal chords could not be viewed with the GlideScope. ⋯ A "cannot ventilate, cannot intubate" situation ensued and an emergency tracheotomy was carried out. The case described makes it clear that neither modern devices nor experience from previous anesthesia can reliably guarantee a safe airway management.