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August 29, 1959, Vol 170, No. 18 >

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ARTICLE | August 29, 1959

INTRATHECAL USE OF METHYLENE BLUE

Bernard J. Sivak, M.D.
JAMA. 1959;170(18):2232. doi:10.1001/jama.1959.03010180084023.
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ABSTRACT

To the Editor:—  Dr. Joseph Evans (J. A. M. A.169:526 [Jan. 31] 1959) recently communicated a warning on the use of methylene blue intrathecally and reported a case of his own that resulted in paraplegia. I wonder how the ampul of methylene blue was stored and how it was sterilized. Ampuls of this drug are usually kept in a detergent solution or alcohol or phenol solution so as to be ready for immediate use. Microscopic cracks in ampuls can allow entrance of these neurotoxic solutions without any apparent external sign. Spinal anesthesia has been held responsible for paraplegia when the storage solution was actually at fault. Autoclaving of all ampuls that are to be administered intrathecally is sine qua non. They should never be immersed in solutions, It is interesting to see the similarity in the condemnation of spinal anesthesia and of methylene blue in this report.

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