Systemic vasoplegia is common in patients undergoing liver transplantation. In this report,
we present a case in which treatment with conventional vasopressors caused peripheral
arterial spasm, rendering arterial blood pressure monitoring impossible. Administration of
methylene blue resolved the vasospasm; however, concern for toxic dose requirements
limited its use. Hydroxocobalamin administration resolved the vasospasm and increased
blood pressure without the potential adverse effects seen with methylene blue. This case …