Effects of methylene blue on propofol requirement during anaesthesia induction and surgery

Anaesthesia. 2008 Apr;63(4):352-7. doi: 10.1111/j.1365-2044.2007.05354.x.


Delayed emergence from anaesthesia and neurological disturbances have been reported in patients undergoing parathyroidectomy who received methylene blue (MB) pre-operatively. We hypothesised that MB would decrease propofol requirements. The Bispectral index (BIS) and a target-controlled infusion of propofol were used in two groups of 11 matched patients. Patients in one group were pretreated with MB. During induction, clinical sedation scores and BIS values were significantly lower at the predicted effect-site propofol concentration of 2 microg x ml(-1) in the MB compared with the control group. Intra-operatively, although similar BIS values were achieved in the two groups, patients pretreated with MB required a mean 50% lower dose of propofol compared with controls. In view of these findings, care should be taken to ensure an adequate depth of anaesthesia by titrating the administration of anaesthetic agents whenever MB is infused peri-operatively.

MeSH terms

  • Aged
  • Anesthesia, Intravenous / methods
  • Anesthetics, Intravenous / administration & dosage*
  • Case-Control Studies
  • Coloring Agents / pharmacology*
  • Drug Administration Schedule
  • Drug Synergism
  • Electroencephalography / drug effects
  • Female
  • Humans
  • Male
  • Methylene Blue / pharmacology*
  • Middle Aged
  • Parathyroidectomy
  • Propofol / administration & dosage*


  • Anesthetics, Intravenous
  • Coloring Agents
  • Methylene Blue
  • Propofol