| Objective:Further explore the methylene blue long-acting analgesic used in mixed hemorrhoid postoperative analgesia best concentration,for clinical rational use of methylene blue long-acting analgesic to provide the reference.Methods:A total of 90 inpatients diagnosed with mixed hemorrhoids in the Anorectal Department of Integrated Traditional Chinese and Western Medicine of Nanhong Central Hospital from July 2021 to December 2021 were selected.According to the inclusion criteria,they were divided into three groups with high,medium and low concentration according to the admission time,30 cases in each group.All three groups received lumbar acupoint anesthesia,and after successful anesthesia,external and internal rigid injection combined with RPH was performed.In the high concentration group,0.33%methylene blue long-acting analgesic was subcutaneously injected around the anus,in the medium concentration group,0.2%methylene blue long-acting analgesic was subcutaneously injected around the anus,and in the low concentration group,0.09%methylene blue long-acting analgesic was subcutaneously injected around the anus.Record of three groups of patients for the first time defecation postoperative pain score,6h and postoperative ld,3d,5d,7d and 14d resting first defecation time,postoperative pain score,the 24h urine flow conditions,5d postoperative anal edema,anus control function,the edge healing time,postoperative additional use of painkillers,anus periderm skin sensation recovery time,adverse reactions The follow-up included pain,adverse reactions,wound healing,recurrence,etc.Univariate analysis of variance was used to collect the quantitative data,and the data were expressed as mean±standard deviation(χ±SD).Chi-square test was used for counting data,and p<0.05 was considered statistically significant in all tests.Results:The score of first postoperative defecation in the high concentration group was lower than that in the medium concentration group and the low concentration group(P<0.05),and there was no statistical difference in the score of first postoperative defecation pain between the medium concentration group and the low concentration group(P>0.05).There was no significant difference in pain score between high concentration group and medium concentration group 6h after operation(P>0.05),but the pain score of high and medium concentration group was lower than that of low concentration group.The pain score of the high concentration group was lower than that of the low and medium concentration groups on day 1 and 3 after surgery(P<0.05),and the pain score of the medium concentration group was lower than that of the low concentration group,with statistical difference(P<0.05).There was no significant difference between high and medium concentrations of anal edema on the 5th day after operation(P>0.05),but the scores of anal edema in the two concentrations were lower than those in the low concentration group.There was statistical difference in the use of analgesics among the three groups(P<0.05),the additional use of analgesics in the high concentration group and medium concentration group was significantly lower than that in the low concentration group(P<0.05),and there was no significant difference in the additional use of analgesics between the high concentration group and medium concentration group(P>0.05).The comparison of perianal skin sensation recovery time among the three groups was statistically significant(P<0.05).The comparison of perianal skin sensation recovery time was as follows:high concentration group<medium concentration group<low concentration group;There were no significant differences among the three groups in gender,age,number of external hemorrhoids incisions,number of internal hemorrhoids ligation,time of first postoperative defecation,24h postoperative urination patency,wound healing time and pain score in the resting state at 5d,7d and 14d after surgery(P>0.05).Some patients in the experimental group showed transient light blue urine when they urinated for the first time after mixed hemorrhoids surgery,and did not feel obvious urethral orifice pain and other discomfort.In the high concentration group,two patients showed transient perianal skin burning pain,and the other patients showed no adverse reactions during hospitalization and discharge follow-up visits.Conclusion:0.2%concentration of methylene blue long-acting analgesic in mixed hemorrhoid postoperative analgesia effect is remarkable,early postoperative and first bowel movement analgesia effect is less than 0.33%concentration of methylene blue long acting analgesic,but the concentration can effectively reduce the anus periderm skin feel recovery time,reduce adverse reactions,and the concentration of 0.2%compared with 0.09%concentration of methylene blue long-acting analgesic,It can significantly reduce perianal edema and additional use of painkillers.In comparison,the 0.2%methylene blue long-acting analgesic has better comprehensive effect than the other two concentrations and is more suitable for clinical promotion. |
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