The safety of intravenous fluorescein administration

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 anesthesiologist 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 (greater than or equal to 30 minutes) or transient (less than or equal to 15 minutes) differences in pressure changes after fluorescein administration. No significant (p less than or equal to 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.