不同浓度亚甲蓝联合罗哌卡因在混合痔外剥内扎术后镇痛中的应用研究

Objective To compare the analgesic effects, complications, and postoperative recovery indicators of two different concentrations of methylene blue combined with ropivacaine for local injection after external dissection and internal ligation of mixed hemorrhoids, and to identify an optimal drug formulation with safe and long-lasting analgesic effects, providing clinical evidence for prolonged local analgesia after anorectal surgery. Methods A total of 80 patients who underwent external dissection and internal ligation of mixed hemorrhoids in the Department of Anorectal Surgery of our hospital from January 2024 to January 2025 were enrolled and randomly divided into the control group and the observation group, with 40 patients in each group. After the operation, corresponding mixed analgesic solution was injected pointwise into the perianal wound. Visual Analogue Scale(VAS) pain scores at various time points after the operation, the incidence of complications, the time of the first defecation, and the length of hospital stay were analyzed. Results The VAS pain scores at 6 h, 24 h, 48 h, and 72 h after surgery in the observation group were significantly lower than those in the control group(P<0.05). The total incidence of complications was 10.00% in the observation group, which was significantly lower than 27.50% in the control group. The time to first defecation and length of hospital stay in the observation group were shorter than those in the control group, with statistically significant differences between the two groups(P<0.05). No severe adverse events, such as perianal skin necrosis, occurred in either group. Conclusion Local infiltration injection of 0.10% methylene blue combined with 0.30% ropivacaine after external dissection and internal ligation of mixed hemorrhoids provides longer-lasting analgesia, reduces postoperative complications, and accelerates patient recovery. This regimen demonstrates good clinical safety and may be recommended as a preferred formulation for long-acting local analgesia after anorectal surgery.