VTE prophylaxis for breast surgery; A prospective audit

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Introduction: Patent Blue V dye is routinely used in the UK for Sentinel Lymph node biopsy.However, it causes allergic reactions in (0.6-2.7%).The NEWSTART and ALMANAC studies have reported 1% incidence.The ABS guidelines 2009, recommends routine consenting for blue dye administration and allergic reactions.Materials and Methods: We looked into 41 cases of WLE/Mastectomy with SLNB done over a 3 month period.All patients had 2ml of 2.5% PBV injected subareolarly.Results: 50% were consented for administration, and only 50% had allergic responses mentioned.One patient had allergic reaction to blue dye manifesting as intaoperative hypotension requiring ephedrine.There were no delayed effects.Urticarial rashes, blue hives were seen in 3 patients but were self-limiting.A similar audit done at a regional tertiary centre, the consenting rates where 65% despite using pre-printed consent forms because pre-printed consent forms were not used in all patients.Conclusion: Patent Blue dye injection is not without risks and therefore PBV administration and allergic responses to patent blue dye should routinely be mentioned in consent forms.Using pre-printed forms can improve the consenting rates, but it requires more awareness and persuation among doctors.

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