Methylene Blue for the Therapy of Intractable Ache Related to Oral Mucositis.
Ache Pract. 2017 Nov;17(eight):1115-1121
Authors: Roldan CJ, Nouri Okay, Chai T, Huh B
Oral mucositis is a standard and sometimes debilitating complication amongst most cancers sufferers receiving radiation remedy to the pinnacle and neck or chemotherapy brokers, or present process hematopoietic stem cell transplantation. Ache and decreased oral perform related to oral mucositis might persist lengthy after the conclusion of remedy. Though most sufferers reply to conservative administration, a subset of sufferers develops intractable ache with extreme penalties. For some, using whole parenteral vitamin with insertion of percutaneous endoscopic gastrostomy feeding tubes is the one different. Present suggestions to deal with mucositis and its associated ache embody fundamental oral care, bland oral rinses, topical anesthetics, and systemic analgesics. We imagine that chemical neurolysis of the affected areas with methylene blue used as an oral rinse is a noninvasive, environment friendly, protected, and cost-effective different that may present extended analgesia in sufferers with intractable ache of oral mucositis. The advantages of this remedy are mirrored in its enchancment of sufferers’ high quality of life by enabling oral feeding and controlling ache. We report a collection of 5 consecutive sufferers with intractable oral mucositis-related ache regardless of standard therapy with systemic opiates. All 5 sufferers responded effectively to using zero.05% methylene blue as mouth rinse, demonstrating sustained analgesia over three weeks. The therapy was tolerated effectively, and total affected person satisfaction was very excessive. We additionally noticed that methylene blue rinse considerably decreased the whole opioid requirement, as demonstrated by reductions within the sufferers’ morphine equal each day dose scores after its use. Our case collection means that zero.5% methylene blue oral rinse remedy is an efficient and cheap modality that can be utilized safely to palliate intractable oral ache in sufferers with mucositis related to most cancers therapy. To our data, that is the primary report utilizing this remedy to deal with ache from oral mucositis.
PMID: 28226414 [PubMed – indexed for MEDLINE]