Dr Robinson's letter highlighting the potential adverse reactions associated with Patent Blue V (Guerbet, Cedex, France) [1] is a useful reminder to anaesthetists of an adverse drug reaction that they may not have administered but will be expected to manage. The use of Patent Blue V dye is becoming more widespread since the publication of the ALMANAC trial [2]. We have been using Patent Blue V dye for almost 10 years and have managed many of the complications of its use [3, 4]. Over 3000 patients have been exposed to this drug and we have found 30 patients to date (approximately 1%) who have experienced severe anaphy-laxis with cardiovascular collapse; this is similar to the 0.86% incidence from the ALMANAC and NEW START datasets [5]. The incidence of anaphy-lactic reactions during anaesthesia is estimated at between 1 in 3500 and 1 in 13000 [6]; with neuromuscular blocking drugs responsible for roughly 60% of reactions, followed by exposure to latex and antibiotics at around 15% each [7]. Our, 1% rate of reaction therefore potentially makes Patent Blue V the most common drug causing severe anaphylaxis in the operating theatre environment.
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机译：Robinson博士的信强调了与Patent Blue V（法国，Cedex，Guerbet，Guerbet）相关的潜在不良反应，这对麻醉师可能没有用药但有望治疗的不良药物反应是一个有益的提醒。自ALMANAC试验发表以来[2]，专利Blue V染料的使用变得越来越广泛。我们使用专利蓝V染料已有近10年的时间，并且已经解决了使用它的许多复杂问题[3，4]。已有超过3000名患者接触了这种药物，到目前为止，我们发现30例患者经历了严重的厌氧性轴心病并伴有心血管衰竭。这与ALMANAC和NEW START数据集的0.86％发生率相似[5]。麻醉期间厌氧-乳酸反应的发生率估计为3500分之1和13000分之1 [6]。用神经肌肉阻滞药负责大约60％的反应，然后以大约15％的比例暴露于乳胶和抗生素[7]。因此，我们1％的反应率有可能使Patent Blue V成为引起手术室环境严重过敏反应的最常见药物。
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