CN103463092A - Long-acting pain relieving mixture used after anorectal surgery - Google Patents
Long-acting pain relieving mixture used after anorectal surgery Download PDFInfo
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- CN103463092A CN103463092A CN2013103897832A CN201310389783A CN103463092A CN 103463092 A CN103463092 A CN 103463092A CN 2013103897832 A CN2013103897832 A CN 2013103897832A CN 201310389783 A CN201310389783 A CN 201310389783A CN 103463092 A CN103463092 A CN 103463092A
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Abstract
The invention belongs to the field of medicines, and provides a long-acting pain relieving mixture used after anorectal surgery. The long-acting pain relieving mixture is prepared from methylene blue injection, promethazine hydrochloride injection, lidocaine hydrochloride injection and sodium chloride injection in certain proportion, has a long-acting pain relieving effect after surgery and can also be used for solving local burning pain caused within 3-4 hours. Compared with a conventional local injection long-acting pain relieving mixture, the long-acting pain relieving mixture has the obvious advantages of definite curative effect, long-acting pain relieving and no side effects. The long-acting pain relieving mixture is suitable for infiltrating injection below wound surface mucosae after anorectal surgery such as hemorrhoids, anal fissure, anal fistula and rectocele.
Description
Technical field
The invention belongs to technical field of pharmaceuticals, relate to the long-acting analgesic medicine of local injection, specifically the postoperative long-acting analgesic combination of a kind of anorectal.
Background technology
Hemorrhoid comprise internal hemorrhoid, external hemorrhoid, mixed hemorrhoid, are one of clinical common frequently-occurring diseases.Patient's postoperation local pain is the problem that the doctor of anorectal section pays close attention to most for many years.Clinical discovery in recent years, traditional methylene blue adds lidocaine hydrochloride (or bupivacaine), the long-acting analgesic combination of sodium chloride solution, can solve the postoperative pain problem of hemorrhoid patient, and its analgesic effect reaches 1-3 week.But, the long-acting analgesic combination that the postoperation topical application is traditional, due to the side effect of methylene blue, the oxidation to local mucous membrane and anal canal smooth muscle in 3-4 hour stimulates anaphylaxis, allows the most humans hurt like hell, burns pain obviously, and patient is very painful.
The inventor is in clinical practice for many years, find that traditional long-acting analgesic combination of the postoperative local injection of hemorrhoid exists certain defect, after the hemorrhoid clinical operation, to solving the local pain produced in 3-4 hour, the problem of burning pain has eager demand, yet there are no so far relevant report.
Summary of the invention
The object of the present invention is to provide the postoperative long-acting analgesic combination of a kind of anorectal, can solve preferably the existing problem of conventional art, for the patient considers, remove painful.
The technical solution used in the present invention is the postoperative long-acting analgesic combination of a kind of anorectal of design, adopt following medicine formulated: 1% methylene blue injection 2-4ml, 1.25% promethazine hydrochloride inj 1-2ml, 2% lidocaine hydrochloride injection 2-4ml, 0.9% sodium chloride injection 2-4ml.
The main component of local long-acting analgesic is methylene blue, and it is a kind of reductant-oxidant, reversibility, anaphylaxis antipsychotic drugs.After local injection, in 3-4 hour, can make amyelinated nerve fiber painted, thereby stop sensorineural conduction, the involved in sugar metabolism, can promote the continuation oxidation of acetone acid, improves teleneuron film inside and outside salt soda balance and transmembrane potential, thereby neural impulse is obstructed.And it can also affect the lipid within endothelial cells metabolism, thereby play the nerve block effect, make teleneuron produce a kind of anaphylaxis paralysis, topodysesthesia, the pain sensation lowers or disappears, but sphincter function is normal, therefore can not cause the short time anal incontinence, can prevent sphincterismus, thus the generation of local pain and reflexive urine retention while avoiding performing the operation rear stool, the local analgesia effect continues 1-3 week aftersensation and recovers gradually, and methylene blue enters blood by renal excretion.After the methylene blue local injection, can have side effects, after injection in 3-4 hour, due to local histiocyte is produced to redox reaction, severe irritation mucosal tissue and produce strong pain, burning sensation, cause very large misery to the patient.
The present invention adds promethazine hydrochloride inj in traditional long-acting analgesic combination, and promethazine hydrochloride is H
1receptor antagonist, energy competitive antagonism histamine is to anal canal smooth muscle contraction or spasm hyperemization, reduce the allergic stimulated symptom that methylene blue causes the redox reaction of local organization, and the stable effect of significant maincenter is arranged, can strengthen the paroxysmal pain effect of local anaesthetics.
Methylene blue, promethazine hydrochloride, lidocaine hydrochloride, the sodium chloride injection drug combination, do not have incompatibility.Promethazine hydrochloride can alleviate or offset methylene blue and inject in latter 3-4 hour, stimulation to local mucous membrane and anal canal smooth muscle, the local causalgia sense caused, to the maincenter psychosis, the paroxysmal pain effect of local anaesthetics lidocaine hydrochloride or bupivacaine has been strengthened again in effect simultaneously.Compare with the long-acting analgesic combination of existing local injection, there is long-acting pain relieving, have no side effect, remove the operation remarkable advantage of local pain sense and burning sensation in 3-4 hour afterwards.
The specific embodiment
The present invention adopts following medicine formulated: 1% methylene blue injection 2-4ml, 1.25% promethazine hydrochloride inj 1-2ml, 2% lidocaine hydrochloride injection 2-4ml, 0.9% sodium chloride injection 2-4ml.
The present invention adopts following medicine formulated: 1% methylene blue injection 2ml(20mg), and 1.25% promethazine hydrochloride inj 1ml (25mg), 2% lidocaine hydrochloride injection 2ml (40mg), 0.9% sodium chloride injection 2ml.
Preparation method: said medicine is pressed to the proportional quantity mix homogeneously, be made into mixture.
Usage and dosage: the treatment case, all, in operation fully hemostasis afterwards, then with mixture of the present invention, evenly be expelled to operation and hinder under the face mucosa, dosage is hindered the face size according to operation, how much appropriately adjusts, between 2ml-7ml.
Clinical observation:
1, physical data: in treatment group 160 examples, male 68 examples, account for 42.5%, and female's 92 examples, account for 57.5%; Minimum 16 years old of age, maximum 80 years old, average 49.5 years old; Disease time is the shortest 3 days, the longest 5 years, average 78 days; Occupation distributes, and peasant's 66 examples, account for 41.25%, and cadre's 49 examples, account for 30.625%, and student's 12 examples, account for 7.5%; Other 33 examples, account for 20.625%; 160 routine hemorrhoid classification, internal hemorrhoid 76 examples, account for 47.5%, and mixed hemorrhoids 63 examples, account for 39.375%; External hemorrhoid 21 examples, account for 13.125%.Matched group 50 examples, the substantially same treatment group of general status.
2, diagnostic criteria: in postoperation 3-4 hour, operative site has and significantly burns pain.
3, Therapeutic Method: treatment group is all first with lidocaine hydrochloride injection crissum local infiltration anesthesia after the sodium chloride injection dilution.After the anesthesia onset, internal hemorrhoid adopts ligation, and mixed hemorrhoid adopts in outer stripping and pricks art, and external hemorrhoid adopts the surgical incision decollement.
Above treatment case, all, in operation fully hemostasis afterwards, then evenly be expelled to operation with mixture of the present invention and hinder under the face mucosa, and dosage is hindered the face size according to operation, how much does suitable adjustment, between 2ml-7ml.Matched group is according to the long-acting analgesic combination compound method of tradition, and 1% methylene blue injection 2ml, 2% lidocaine hydrochloride injection 2ml, 0.9% sodium chloride injection 2ml, still at postoperation, hinder infiltration injecting under the face mucous layer.
4, efficacy assessment standard
Efficiently: after operation, in 3-4 hour, operative site is without any burning pain perception or irritation.
Produce effects: after operation in 3-4 hour, operative site burn pain or irritation obviously alleviates.
Effectively: after operation in 3-4 hour, operative site burn pain or irritation alleviates to some extent, but still more painful.
Invalid: after operation, in 3-4 hour, operative site burns pain or irritation is very serious, still very painful.
5, efficacy analysis (seeing the following form)
| Grouping | N | Efficiently | Produce effects | Effectively | Invalid |
| Treatment group | 160 | 152（0.95） | 6（0.375） | 2（0.125） | 0 |
| Matched group | 50 | 2（0.04） | 6（0.12） | 7（0.14） | 35（0.70） |
Learn by statistics the processing curative effect for two groups and have significant difference, the treatment group postoperation, hinder face local infiltration injection mixture of the present invention, wherein promethazine hydrochloride antagonism methylene blue due to irritated oxidation reaction, calcination pain in the stimulation of local mucous membrane and anal canal smooth muscle is caused 3-4 hour, total effective rate 100%, effect is ideal.Matched group, still used traditional long-acting analgesic combination, and after operation, 70% patient's calcination pain is obvious, and the treatment group successful is higher than matched group (P<0.01).
6, case of illness introduce
The patient, male, 60 years old, on July 9th, 2011, with " during stool, the swollen thing of anal deviates to accompany pain 1 year, increases the weight of first quarter moon, be chief complaint into cure the disease people's ordinary circumstance can, anus inspection; see the bulk thing that swell, place emerges in the anus edge respectively at anus calculi position 3.7.11 point, differs in size; surperficial kermesinus, and swelling is obvious, and hand push can return and include anal in; rectal touch, anus one finger, mucous membrane of rectum smooth surface; tenderness is obvious, and without lump, fingerstall is without staining.Be diagnosed as mixed hemorrhoid.
After improving inspection, prick art in shelling outside local anaesthesia down mixing hemorrhoid on July 10th, 2011, postoperatively hinder infiltration injecting mixture of the present invention under face and internal hemorrhoid basilar part mucosa, in the postoperative 3-4 of patient hour, without burning sensation and irritant reaction, local only have a numb sensation, postoperative to the discharged patient without the pain stimulation symptom.Local sensory recovery after two weeks, follow up a case by regular visits to after 1 year and have no recurrence and sense of discomfort.
Through a large amount of clinical observations, mixture of the present invention is hindered infiltration injecting under the face mucosa after also being useful in the anal-surgeries such as anal fissure, anal fistula, proctoptosis, plays and the postoperative medication same purpose of hemorrhoid.
Mixture of the present invention, compatibility is reasonable, and postoperative long-acting analgesic effect certainly and have no side effect, apply very much by clinic.
Claims (2)
1. the postoperative long-acting analgesic combination of anorectal, is characterized in that adopting following medicine formulated: 1% methylene blue injection 2-4ml, 1.25% promethazine hydrochloride inj 1-2ml, 2% lidocaine hydrochloride injection 2-4ml, 0.9% sodium chloride injection 2-4ml.
2. according to the postoperative long-acting analgesic combination of the anorectal of claim 1, it is characterized in that adopting following medicine formulated: 1% methylene blue injection 2ml, 1.25% promethazine hydrochloride inj 1ml, 2% lidocaine hydrochloride injection 2ml, 0.9% sodium chloride injection 2ml.
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114042076A (en) * | 2021-12-20 | 2022-02-15 | 刘惠君 | Anus postoperative analgesia technology |
| CN115068485A (en) * | 2022-06-30 | 2022-09-20 | 韩宝 | Methylene blue compound preparation for long-acting pain relief after anorectal surgery and preparation method |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103239456A (en) * | 2013-04-26 | 2013-08-14 | 临江市妇幼保健院 | Pharmaceutical composition for easing pain and use thereof |
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- 2013-09-02 CN CN2013103897832A patent/CN103463092A/en active Pending
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103239456A (en) * | 2013-04-26 | 2013-08-14 | 临江市妇幼保健院 | Pharmaceutical composition for easing pain and use thereof |
Non-Patent Citations (1)
| Title |
|---|
| 邸英莲等: ""肛肠病术后疼痛的研究进展"", 《当代护士》, no. 10, 31 October 2013 (2013-10-31), pages 11 - 13 * |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114042076A (en) * | 2021-12-20 | 2022-02-15 | 刘惠君 | Anus postoperative analgesia technology |
| CN115068485A (en) * | 2022-06-30 | 2022-09-20 | 韩宝 | Methylene blue compound preparation for long-acting pain relief after anorectal surgery and preparation method |
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Application publication date: 20131225 |