Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled study
Abstract Objective This study aims to explore the analgesic effects and safety of periarticular injections of methylene blue (MB) combined with a cocktail formulation following total knee arthroplasty (TKA). Methods A total of 70 patients undergoing total knee arthroplasty were selected and divided...
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BMC
2025-01-01
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| Series: | Perioperative Medicine |
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| Online Access: | https://doi.org/10.1186/s13741-025-00493-0 |
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| author | Yijiang Deng Yong Yang Feng Zhu Wenzhi Liu Jiarui Chen Guangmin Xu |
| author_facet | Yijiang Deng Yong Yang Feng Zhu Wenzhi Liu Jiarui Chen Guangmin Xu |
| author_sort | Yijiang Deng |
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| description | Abstract Objective This study aims to explore the analgesic effects and safety of periarticular injections of methylene blue (MB) combined with a cocktail formulation following total knee arthroplasty (TKA). Methods A total of 70 patients undergoing total knee arthroplasty were selected and divided into two groups based on the cocktail formula used for periarticular infiltration, including the methylene blue group (M group, n = 35) and the control group (C group, n = 35). Both groups underwent spinal anesthesia. At the end of the surgery, the M group received a 0.05% methylene blue combined cocktail for periarticular infiltration block, while the C group received a conventional cocktail infiltration block. Postoperatively, both groups used intravenous patient-controlled analgesia. Then, the rest and movement Numeric Rating Scale (NRS) scores, postoperative sufentanil consumption, postoperative inflammatory markers, and the occurrence of adverse reactions such as wound infection and poor wound healing were compared after postoperative 24 h, 48 h, 72 h, and 7-day, 14-day, 28-day between the two groups. Results The rest and during movement, NRS scores at postoperative 24 h, 48 h, 72 h, 7-day, 14-day, and 28-day were significantly lower in the C group compared with the M group (P < 0.05). The total sufentanil consumption at postoperative 72 h was less in the M group (98.9 ± 11.3 µg) compared to the C group (129.1 ± 12.3 µg) (P < 0.01). It also showed a lower IL-6 in the M group at postoperative 24 h and 72 h (P < 0.05). However, there were no significant differences in CRP levels between the two groups at 24 h and 72 h post-surgery (P > 0.05), and neither group experienced complications such as wound infection or poor wound healing. Conclusion Methylene blue combined with a cocktail can be safely used for local infiltration after knee arthroplasty, which reduces postoperative opioid consumption and suppresses the release of inflammatory factors. Moreover, it synergistically enhanced the local anesthetic analgesia and provided sustained pain relief for at least 4 weeks. |
| format | Article |
| id | doaj-art-49a58be30a734c35bb220fe9f86e57ad |
| institution | Kabale University |
| issn | 2047-0525 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj-art-49a58be30a734c35bb220fe9f86e57ad2025-01-26T12:45:04ZengBMCPerioperative Medicine2047-05252025-01-011411710.1186/s13741-025-00493-0Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled studyYijiang Deng0Yong Yang1Feng Zhu2Wenzhi Liu3Jiarui Chen4Guangmin Xu5Department of Anesthesiology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaDepartment of Orthopedics, Affiliated Hospital of Panzhihua UniversityDepartment of Anesthesiology, Affiliated Hospital of Panzhihua UniversityDepartment of Anesthesiology, Affiliated Hospital of Panzhihua UniversityDepartment of Anesthesiology, Affiliated Hospital of Panzhihua UniversityDepartment of Anesthesiology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of ChinaAbstract Objective This study aims to explore the analgesic effects and safety of periarticular injections of methylene blue (MB) combined with a cocktail formulation following total knee arthroplasty (TKA). Methods A total of 70 patients undergoing total knee arthroplasty were selected and divided into two groups based on the cocktail formula used for periarticular infiltration, including the methylene blue group (M group, n = 35) and the control group (C group, n = 35). Both groups underwent spinal anesthesia. At the end of the surgery, the M group received a 0.05% methylene blue combined cocktail for periarticular infiltration block, while the C group received a conventional cocktail infiltration block. Postoperatively, both groups used intravenous patient-controlled analgesia. Then, the rest and movement Numeric Rating Scale (NRS) scores, postoperative sufentanil consumption, postoperative inflammatory markers, and the occurrence of adverse reactions such as wound infection and poor wound healing were compared after postoperative 24 h, 48 h, 72 h, and 7-day, 14-day, 28-day between the two groups. Results The rest and during movement, NRS scores at postoperative 24 h, 48 h, 72 h, 7-day, 14-day, and 28-day were significantly lower in the C group compared with the M group (P < 0.05). The total sufentanil consumption at postoperative 72 h was less in the M group (98.9 ± 11.3 µg) compared to the C group (129.1 ± 12.3 µg) (P < 0.01). It also showed a lower IL-6 in the M group at postoperative 24 h and 72 h (P < 0.05). However, there were no significant differences in CRP levels between the two groups at 24 h and 72 h post-surgery (P > 0.05), and neither group experienced complications such as wound infection or poor wound healing. Conclusion Methylene blue combined with a cocktail can be safely used for local infiltration after knee arthroplasty, which reduces postoperative opioid consumption and suppresses the release of inflammatory factors. Moreover, it synergistically enhanced the local anesthetic analgesia and provided sustained pain relief for at least 4 weeks.https://doi.org/10.1186/s13741-025-00493-0Total knee arthroplastyMethylene blueCocktailPeriarticular infiltrationAnalgesia |
| spellingShingle | Yijiang Deng Yong Yang Feng Zhu Wenzhi Liu Jiarui Chen Guangmin Xu Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled study Perioperative Medicine Total knee arthroplasty Methylene blue Cocktail Periarticular infiltration Analgesia |
| title | Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled study |
| title_full | Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled study |
| title_fullStr | Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled study |
| title_full_unstemmed | Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled study |
| title_short | Analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty: a prospective, randomized, controlled study |
| title_sort | analgesic efficacy and safety of methylene blue combined with cocktail for periarticular infiltration following total knee arthroplasty a prospective randomized controlled study |
| topic | Total knee arthroplasty Methylene blue Cocktail Periarticular infiltration Analgesia |
| url | https://doi.org/10.1186/s13741-025-00493-0 |
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