Published: 2022-07-26

A study of analgesic effect of methylene blue injection in post conventional haemorrhoidectomy

Aafrin S. Baldiwala, Mitesh R. Trivedi


Background: Haemorrhoids are common perianal disease. Milligan-Morgan haemorrhoidectomy operation is a classical haemorrhoid resection procedure that has been widely used as gold standard.  Classical haemorrhoidectomy is associated with considerable postoperative pain. This leads to patient discomfort; prolonged hospital stays and increased cost. The causes of post haemorrhoidectomy pain are multifactorial. Methylene blue has been widely used as biological dye. It is an inhibitor of soluble guanylate cyclase. It has also been found to reduce cyclooxygenase products. The mechanism of action of methylene blue is likely to be related to the destruction of dermal nerve endings.

Methods: A prospective study of 114 indoor patients was conducted to compare the effects of 1% intradermal methylene blue injection at local site and injection paracetamol (I.V.) as per requirement after Milligan-Morgan haemorrhoidectomy admitted to Surat municipal institute of medical education and research (SMIMER) hospital at Department of General Surgery. Samples were divided into two groups each of 57 patients, in case group patients were given intradermal methylene blue at local site after haemorrhoidectomy and in both groups’ injection paracetamol was given as per requirement. Both groups are assessed by visual analogue scale (VAS).

Results: Present study concluded that mean post-operative score according visual analogue scale (VAS) in case group was significantly lower as compared to control group on 1st and 3rd post-operative day.

Conclusions: Methylene blue injection has an analgesic effect at local site after post conventional haemorrhoidectomy without any significant side effects of methylene blue.



Methylene Blue, Milligan-Morgan haemorrhoidectomy, Open haemorrhoidectomy, Post-operative pain

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