Methylene Blue Long-acting Analgesic Is Used To Study The Analgesic Effect Of Hemorrhoid Surgery

Background:Hemorrhoids are common and frequently-occurring diseases in the Department of proctology.When hemorrhoids develop to a certain extent or incarcerate or erosive necrosis occurs,conservative treatment has little effect and only surgical treatment can be selected.However,the nerves below the dentate line of the anus are sensitive,blood vessels and lymph nodes are abundant,and the stimulation of the operation often causes severe pain,anal sphincter spasm,causing more serious systemic symptoms,such as edema,urinary retention,even elevated blood pressure and heart rate,which reduces the quality of life and affects the therapeutic effect.Although there are many ways to relieve pain at present,they all have certain shortcomings.Methylene blue long-acting analgesic is a commonly used analgesic method in the Department of proctology.It has the advantages of definite analgesic effect,long duration,low price and simple operation.The analgesic effect of methylene blue long-acting analgesic is related to its concentration,but there is no uniform view on the optimal concentration of methylene blue for mixed hemorrhoids after operation.Obj ective:To explore the suitable concentration of methylene blue long-acting analgesic for mixed hemorrhoids after operation,and to provide reference for clinical selection of the concentration of methylene blue long-acting analgesic.Methods:From September 2018 to February 2019,64 patients with mixed hemorrhoids who were hospitalized in Proctology Department of Guang’anmen Hospital,Chinese Academy of Traditional Chinese Medicine were randomly divided into high concentration group and low concentration group,32 cases in each group.Subarachnoid block anesthesia was used in both groups.Mixed hemorrhoidectomy and ligation of internal hemorrhoids were performed in both groups.In high concentration group,0.2%methylene blue long-acting analgesic was injected into wound infiltration after operation.In low concentration group,0.1%methylene blue long-acting analgesic was injected into wound infiltration after operation.The rest pain score,first defecation time,pain score after first defecation,use of analgesics,edema,urination and adverse reactions of the two groups were recorded at 6h and 1st,3rd,5th,7th and 14th day after operation.The patients were followed up at 2nd week,1st month and 3rd month after operation,including pain,adverse reactions,wound healing and recurrence situation and so on.SPSS20.0 statistical software was used to analyze the data.When the measurement data satisfy the normal distribution and the variance is homogeneous,independent sample t test was used,and rank sum test was used when it is not satisfied.Rank sum test was used for rank data.Chi-square test was used for counting data.Bilateral tests were used in all tests,and the difference was statistically significant(P<0.05).Results:There were no statistical differences in gender,age,number of incisions for external hemorrhoids and number of ligations for internal hemorrhoids between the two groups(P>0.05).There was no statistical difference in the resting pain score of anal area between the two groups before treatment(P>0.05),6 hours after operation(P>0.05).The resting pain score of the high concentration group was lower than that of the low concentration group at 1,3,5 and 7 days after operation(P<0.05),and there was no statistical difference in the resting pain score of the two groups on the 14th day after operation(P>0.05).There was no significant difference in the first defecation time(P>0.05).After the first defecation,the pain score of the high concentration group was lower than that of the low concentration group(P<0.05).There were no significant differences in the use of analgesics,edema,urination and wound healing between the two groups(P>0.05).No adverse reactions occurred during hospitalization and follow-up.Conclusion:The analgesic effect of 0.2%methylene blue long-acting analgesic is better than that of 0.1%methylene blue long-acting analgesic on the 1st,3rd,5th,7th day and the first defecation after operation,and it has no adverse effect on urination,edema and wound healing.Therefore,0.2%methylene blue long-acting analgesic can effectively relieve the pain of mixed hemorrhoids,compared with 0.1%methylene blue long-acting analgesic.0.10%methylene blue long-acting analgesic is more suitable for mixed hemorrhoids surgery.