Azhough Ramin, Jalali Pooya, Dashti Mohammad Reza, Taher Sahar, Aghajani Ali
Department of General Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Centre, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Surg. 2024 Mar 21;11:1354328. doi: 10.3389/fsurg.2024.1354328. eCollection 2024.
Unbearable post-hemorrhoidectomy pain is a well-documented challenge, significantly impacting patient well-being and satisfaction after surgery, often influencing patients to decline in undergoing this procedure. It is widely recognized that methylene blue has an effect of reducing inflammation and pain by reduces the production of nitric oxide and inhibiting the action potentials production in nerves. This study aims to explore the potential benefits of postoperative regional administration of methylene blue in providing extended relief from post-hemorrhoidectomy pain.
This study included 97 patients aged 18-75 undergoing hemorrhoidectomy for stage III or IV hemorrhoids. A double-blind, randomized controlled trial compared postoperative intradermal injections of 1% methylene blue to 0.5% Marcaine as the control group. Two-week follow-up assessed pain. Statistical analysis, adherence to ethical standards, and registration were conducted.
No significant differences were found in baseline demographics, surgical parameters, or complications between the Methylene Blue and control groups. Intervention group remained lower in mean pain score until the 12th day. Methylene blue group reported significantly lower postoperative pain scores from days 1 to 7, with no significant differences afterward.
This ongoing randomized controlled trial reveals the potential analgesic benefits of intradermal injection 1% methylene blue. It demonstrates comparable efficacy in reducing post-hemorrhoidectomy pain, with negligible side effects and complications.
痔切除术后难以忍受的疼痛是一个有充分文献记载的挑战，对患者术后的幸福感和满意度有重大影响，常常导致患者拒绝接受该手术。人们普遍认为亚甲蓝通过减少一氧化氮的产生和抑制神经动作电位的产生，具有减轻炎症和疼痛的作用。本研究旨在探讨术后局部应用亚甲蓝在延长痔切除术后疼痛缓解方面的潜在益处。
本研究纳入了97例年龄在18至75岁之间、因III期或IV期痔疮接受痔切除术的患者。一项双盲随机对照试验将术后皮内注射1%亚甲蓝与0.5%布比卡因作为对照组进行比较。为期两周的随访评估疼痛情况。进行了统计分析、遵守伦理标准情况及注册登记。
亚甲蓝组和对照组在基线人口统计学、手术参数或并发症方面未发现显著差异。干预组的平均疼痛评分在第12天之前一直较低。亚甲蓝组在术后第1至7天的疼痛评分显著较低，之后无显著差异。
这项正在进行的随机对照试验揭示了皮内注射1%亚甲蓝潜在的镇痛益处。它在减轻痔切除术后疼痛方面显示出相当的疗效，副作用和并发症可忽略不计。
