Methylene Blue as an Analgesic in Stapled Hemorrhoidopexy: AProspective Observational Trial


  • Author- Muhammad Ayub, Shahbaaz Khan, Aziz Ahmad, Muhammad Awais Mughal, Wasim Ahmad


Objective: The objective of this study was to investigate the role of local infiltration of methylene blue as an analgesic in stapled hemorrhoidopexy.


This was a prospective observational trial conducted in a tertiary health care center, Peshawar from July 2021 to June 2022. Inclusion criteria was the presence of grade III hemorrhoids. The study population was divided group A being labelled as case whereas, group B was labelled as control. GroupApatients were administered a perianal injection of 2mL methylene blue (1%) along with 10mL bupivacaine (25%) whereas, group B patients were administered a perianal injection of 2mL normal saline along with 10mL bupivacaine (25%). Follow-up was done prospectively for any surgical complication, pain and hospital stay.


 The results of our study revealed that on day 3 and day 7, study participants in group A undergone significantly lower pain scores in comparison to group B at 3rd and 7th day While insignificant at 1st and 21st day. Group B participants had consumed a significantly higher number of diclofenac on day 1 (p value = 0.006) and between days 7 and 21 with p value = 0.000.Only 2 (5.71%) patients in group B observed a prolonged hospital stay because of having pain severity.


  Local infiltration of methylene blue may be used as an effective analgesic in PPH patients with a decreased morbidity so should be used in these patients with confidence.


Methylene blue, Hemorrhoidopexy, Analgesics, Pain score