The Safety of Intravenous Fluorescein Administration

Abstract

Intravenous fluorescein is frequently used to assess tissue perfusion and predict flap viability, although its safety has recently been questioned due to cardiovascular side effects. Vital signs of 50 patients who received fluorescein were monitored by anesthesiologists to assess flap viability. Blood pressure readings were recorded at 5-minute intervals for at least 1 hour before and after fluorescein administration. Repeated measure analysis of variance was performed to determine any significant sustained (≥ 30 minutes) or transient (≤ 15 minutes) differences in pressure changes after fluorescein administration. No significant (p ≤ 0.1) differences in pressure were noted for any identifiable group of patients. Minor reactions included transient nausea with no vomiting (5), sustained blood pressure increases of greater than 10% preadministration values (9), transient pressure drops of greater than 10% (10), and sustained pressure drops of greater than 10% (4). These 4 patients responded to increased fluid therapy without need for pressor agents.