Pulse Oximetry Desaturation Following The Use Of Isosulfan Blue: Influence Of The Site Of Injection

Abstract

Purpose: To examine the influence of injection site on pulse oximetry oxyhemoglobin saturation (SpO2), following intraoperative injection of isosulfan blue (IB) into breast or cutaneous melanoma regions. Purpose: Anesthetic records of 497 patients with breast cancer and 824 with cutaneous melanoma were reviewed. SpO2 was recorded every 15 minutes from 15 minutes before until 120 minutes after IB injection. Results: The mean SpO2 was lower in the breast than melanoma group at 15-120 minutes after IB injection (p 4% SpO2 decrease) was higher in the breast (20.9%) than melanoma group (1.7%) (p<0.00001). The breast group had a greater maximum SpO2 decrease and lower minimum SpO2 during desaturation (p<0.00001), higher incidence of minimum SpO2<95% (p<0.00001), and earlier desaturation onset (p=0.0088). Risk factors for desaturation of any severity were breast group, higher body mass index, and lower intraoperative FiO2, and for major desaturation were breast group and higher baseline intraoperative SpO2. Conclusion: Injection of IB into breast tissue was associated with a higher incidence, greater severity, and earlier onset of SpO2 desaturation, compared to intradermal injection into the area surrounding cutaneous melanomas.