Diffuse Limb Discoloration with Indigotindisulfonate (Indigo Carmine®) and the Associated Implications

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Anesthesiologists often administer medications through an IV catheter that is distal to a noninvasive blood pressure (NIBP) cuff. We report 2 cases where indigotindisulfonate (Indigo Carmine®) was administered through an IV catheter distal to an NIBP cuff. NIBP cuff inflation after indigotindisulfonate administration resulted in diffuse limb discoloration distal to the NIBP cuff although the IV catheter remained completely within the intact vein. These cases suggest that administration of medications that have the same physical characteristics as indigotindisulfonate under the same conditions (i.e., proximal venous occlusion) could also result in an interstitial distribution of these drugs.

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