Methylene Blue

Mak, Renita S Pushparajah; Liebelt, Erica L.

doi:10.1097/pec.0000000000002526

Cited by 29 publications

(8 citation statements)

References 13 publications

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“…Local anesthetics (benzocaine and lidocaine) and EMLA cream cause methemoglobinemia. [ 48 , 49 ] As methylene blue is converted to leukomethylene blue by nicotinamide adenine dinucleotide phosphate, and leukomethylene blue converts methemoglobin to hemoglobin, methylene blue is used to treat methemoglobinemia. [ 48 ] Methemoglobinemia induced by EMLA cream was treated with methylene blue (Case No.…”

Section: Discussionmentioning

confidence: 99%

Lipid emulsion treatment for local anesthetic systemic toxicity in pediatric patients: A systematic review

Lee,

Kim,

Sohn

2024

Medicine

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Background: Local anesthetic systemic toxicity (LAST) is rare, but fatal; the current widely used treatment is lipid emulsion (LE). The goal of this study was to analyze and review case reports on LE treatment for LAST in pediatric patients. Methods: We performed a systematic review using case reports on LE treatment for LAST in pediatric patients, searching PubMed and Scopus databases to March 2023 using the following keywords: (“local anesthetic toxicity” OR “local anesthetic systemic toxicity” OR LAST”) AND (“newborn” OR “infant” OR “child” OR “children” OR “adolescent” OR “pediatric”) AND (“lipid emulsion” OR “Intralipid”). Results: Our search yielded 21 cases, revealing that nearly 43% patients with LAST were less than 1 year old, and most cases were caused by bupivacaine (approximately 67% cases). “Inadvertent intravascular injection” by anesthesiologists and “overdose of local anesthetics” mainly by surgeons were responsible for 52% and 24% cases of LAST, respectively. LAST occurred in the awake state (52%) and under general anesthesia (48%), mainly causing seizures and arrhythmia, respectively. Approximately 55% of patients received LE treatment in <10 minutes after LAST, mainly improving cardiovascular symptoms. A 20% LE (1.5 mL/kg) dose followed by 0.25 mL/kg/minutes dose was frequently used. LE and anticonvulsants were mainly used in the awake state, whereas LE with or without vasopressors was mainly used under general anesthesia. LE treatment led to full recovery from LAST in 20 cases; however, 1 patient died due to underlying disease. Conclusion: Consequently, our findings reveal that LE is effective in treating pediatric LAST.

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Section: Discussionmentioning

confidence: 99%

Lipid emulsion treatment for local anesthetic systemic toxicity in pediatric patients: A systematic review

Lee,

Kim,

Sohn

2024

Medicine

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“…Methylene blue has been described as increasing blood pressure by preventing vasodilation. It inhibits nitric oxide synthesis and also prevents guanylyl cyclase activation [ 139 ].…”

Section: Methylene Bluementioning

confidence: 99%

“…If clinical symptoms do not resolve, then this dose can be repeated. The maximum dose regardless of body weight is 100 mg [ 139 ].…”

Section: Methylene Bluementioning

confidence: 99%

Antidotes in Clinical Toxicology—Critical Review

Kobylarz,

Noga,

Frydrych

et al. 2023

Toxics

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Poisoning and overdose are very important aspects in medicine and toxicology. Chemical weapons pose a threat to civilians, and emergency medicine principles must be followed when dealing with patients who have been poisoned or overdosed. Antidotes have been used for centuries and modern research has led to the development of new antidotes that can accelerate the elimination of toxins from the body. Although some antidotes have become less relevant due to modern intensive care techniques, they can still save lives or reduce the severity of toxicity. The availability of antidotes is crucial, especially in developing countries where intensive care facilities may be limited. This article aims to provide information on specific antidotes, their recommended uses, and potential risks and new uses. In the case of poisoning, supportive therapies are most often used; however, in many cases, the administration of an appropriate antidote saves the patient’s life. In this review, we reviewed the literature on selected antidotes used in the treatment of poisonings. We also characterised the antidotes (bio)chemically. We described the cases in which they are used together with the dosage recommendations. We also analysed the mechanisms of action. In addition, we described alternative methods of using a given substance as a drug, an example of which is N-acetylcysteine, which can be used in the treatment of COVID-19. This article was written as part of the implementation of the project of the Polish Ministry of Education and Science, “Toxicovigilance, poisoning prevention, and first aid in poisoning with xenobiotics of current clinical importance in Poland”, grant number SKN/SP/570184/2023.

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“…Methylene blue (MB) has been used medically for centuries and is best known as an antidote for acquired methemoglobinemia (MetHB) [ 184 ]. Methylene blue was the first synthetic antimalarial to be discovered [ 185 ], and other common uses include septic shock [ 186 ] and as an intraoperative dye [ 187 ].…”

Section: Miscellaneousmentioning

confidence: 99%

The Use of Natural Bioactive Nutraceuticals in the Management of Tick-Borne Illnesses

Shor

Schweig²

2023

Microorganisms

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The primary objective of this paper is to provide an evidence-based update of the literature on the use of bioactive phytochemicals, nutraceuticals, and micronutrients (dietary supplements that provide health benefits beyond their nutritional value) in the management of persistent cases of Borrelia burgdorferi infection (Lyme disease) and two other tick-borne pathogens, Babesia and Bartonella species. Recent studies have advanced our understanding of the pathophysiology and mechanisms of persistent infections. These advances have increasingly enabled clinicians and patients to utilize a wider set of options to manage these frequently disabling conditions. This broader toolkit holds the promise of simultaneously improving treatment outcomes and helping to decrease our reliance on the long-term use of pharmaceutical antimicrobials and antibiotics in the treatment of tick-borne pathogens such as Borrelia burgdorferi, Babesia, and Bartonella.

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Methylene Blue

Cited by 29 publications

References 13 publications

Lipid emulsion treatment for local anesthetic systemic toxicity in pediatric patients: A systematic review

Lipid emulsion treatment for local anesthetic systemic toxicity in pediatric patients: A systematic review

Antidotes in Clinical Toxicology—Critical Review

The Use of Natural Bioactive Nutraceuticals in the Management of Tick-Borne Illnesses

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