Role of Local Infiltration of Methylene Blue as an Analgesic in Stapled Hemorrhoidopexy: A Prospective Study
Background: Stapled hemorrhoidopexy gained popularity due to low postoperative pain. Few patients still complain of postoperative anal pain. Methylene blue (MB) in caudal and epidural anesthesia gives long-term pain relief and has also been used to treat intractable pruritus ani. Objective: Evaluate...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-03-01
|
| Series: | World Journal of Colorectal Surgery |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/WJCS.WJCS_20_19 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Background:
Stapled hemorrhoidopexy gained popularity due to low postoperative pain. Few patients still complain of postoperative anal pain. Methylene blue (MB) in caudal and epidural anesthesia gives long-term pain relief and has also been used to treat intractable pruritus ani.
Objective:
Evaluate the role of local infiltration of the MB as an analgesic in the procedure for prolapse and hemorrhoids (PPH) surgery.
Design:
Prospective observational study.
Setting:
Tertiary health care center.
Patients and Methods:
Patients with grade-III hemorrhoids were included and were divided into two groups: A and B. Group A received a perianal injection of 2 mL of 1% MB with 10 mL of 25% bupivacaine. Group B received a perianal injection of 2 mL of normal saline with 10 mL of 25% bupivacaine.
Main Outcome Measures:
Patients were followed up prospectively for pain, hospital stay, and complications. Results were noted and compared between the two groups.
Sample Size:
50 patients.
Results:
Group A had significantly lower pain scores on day 3 (mean ± SD 2.08 ± 1.08) and day 7 (mean ± SD 0.64 ± 0.95) as compared to the pain scores on day 3 (mean ± SD 3.92 ± 1.35) (P-value = 0.000) and day 7 (mean ± SD 2.40 ± 1.0) (P-value = 0.000) in group B. Pain scores within first 24 h and day 21 post-surgery were not statistically significant between groups A and B (P-value = 0.286 and 0.19, respectively). Group B required a significantly higher number of both injectable and oral analgesics (mean + SD 4.03 + 0.94) as compared to group A patients (mean + SD 1.97 + 0.81) (P-value = 0.001). 4% of the patients in group B had prolonged hospital stay due to severe pain. Patients in group A also had a significant reduction in their requirement of analgesics. None of the patients who received MB had any local or systemic allergic reactions.
Conclusion:
Local infiltration of MB may be used as an effective analgesic in PPH patients without any increase in morbidity.
Limitations:
Single-center study with a small sample size.
Conflict of Interest:
None. |
|---|---|
| ISSN: | 1941-8213 |