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TREATMENT OF PRURITUS ANI BY INTRACUTANEOUS INJECTIONS OF METHYLENE BLUE


By • Дек 26th, 2010 • Category: Anus

As the observations made by the author on himself and on a series of patients have shown the intracuta-neous injection of a 2 per cent methylene blue in 0.5 per cent novocain render the skin insensitive for a period of 26 to 28 days due to the death of nerve endings stained with methylene blue. This method is applicable only in dry varieties of pruritus ani (not associated with mace­ration, eczema, or moist desquamation).

The patient is placed in the same position as for hemorrhoidectomy. Thirty millilitres of 0,2 per cent methy­lene blue solution plus 3 drops of adrenaline solution (1:1,000) are required. Witn the assistant separating the patient’s buttocks, the surgeon makes an intracutaneous injection, by means of a 2 ml syringe, of methylene blue in novocain (Fig. 132,1), 0.3 to 0,4 ml of solution being introduced per injection. The needle is then withdrawn to be reinserted into the edge of the wheal resulting from the previous injection. The dye should be injected peria-nally. The first series of perianal injections completed, ‘ г second series is started, externally to the first one. In this way the entire anal canal and perianal skin are stained (Fig. 132,2). A dry gauze dressing is applied to the perineum after the injections.

A total of not more than 30 ml of methylene blue so­lution are allowed to be injected. Twenty to 30 minutes after injection the patient, as a rule, has a strong sensa­tion of burning in the area of stained tissues, which lasts for some two and a half flours. The patient’s condition can be considerably alleviated by the local application of ice-bags and Pantopon injections. In 3 to 4 day’s time the stained skin becomes much paler (Fig. 132,3).

The period of complete insensitivity of the skin lasts for 26 days. During that time, beginning with the 5th day after injections, the skin should be lubricated with the following ointment: Sulfaniiamide 3 g: Zinc oxide 1 g; and Zinc ointment 30 g.

Concomitantly, the proctitis should be treated by means of a proper dietary regimen, sulfamides and me­dicinal enemas (100 ml of 0.5 per cent Collarhol solu­tion per enema).

Treatment of pruritus ani by intracutaneous in jections of methylene blue

Fig. 132. Treatment of pruritus ani by intracutaneous in jections of methylene blue:

1. The solution is injected intracutaneously.

2. The anal canal mucosa and perianal skin are stai­ned with methylene blue.

3. The stained skin has become much paler by the fourth day following dye injection.



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