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Patent Blue (Isosulfan Blue)

Overview

Field Detail
Drug class Triphenylmethane dye / Lymphatic mapping agent
Stock formulation 2.5% (25 mg/mL) or 10% (100 mg/mL)
Reconstituted conc. N/A (Ready to use)
Storage Room temp; Protect from light

Preparation

Before you start

Check the concentration. Usually 2.5% (25 mg/mL). Note that Patent Blue and Isosulfan Blue are potent triggers for anaphylaxis and can interfere with pulse oximetry readings.

Equipment needed

  • 1 × Patent Blue 25 mg/mL vial
  • Normal saline (NS) — for IDT dilutions
  • 1 mL syringes × 3 (for test doses/dilutions)
  • 25 G needles

Step 1 — Prepare the SPT solution (25 mg/mL — neat)

  1. Draw up 0.5–1 mL of the stock (25 mg/mL) into a 1 mL syringe.
  2. Label: "Patent Blue SPT 25 mg/mL".

Step 2 — Prepare IDT dilutions

Prepare in this order, using a fresh syringe for each step.

  1. IDT 0.025 mg/mL (1:1,000):
    • Draw 0.1 mL of stock (25 mg/mL) into a 1 mL syringe. Add 0.9 mL NS. Mix. (This is 2.5 mg/mL — 1:10).
    • Draw 0.1 mL of this 2.5 mg/mL into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.25 mg/mL — 1:100).
    • Draw 0.1 mL of this 0.25 mg/mL into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.025 mg/mL — 1:1,000).
    • Label: "Patent Blue IDT 0.025 mg/mL".

Skin prick test (SPT)

Reagent Concentration
Test solution Neat (25 mg/mL)
Positive control Histamine 10 mg/mL
Negative control Normal saline

Interpretation: Wheal ≥3 mm vs negative control = positive.


Intradermal test (IDT)

Dilution series

Step Dilution Concentration Preparation
1 1:1,000 0.025 mg/mL 0.1 mL of 0.25 mg/mL + 0.9 mL NS

Inject: 0.05 mL intradermal. Read at 15–20 minutes.