肛周神经浸润麻醉并痔上黏膜下肌层阻滞麻醉在痔上黏膜环切术中的临床应用

目的评价肛周神经浸润麻醉并痔上黏膜下肌层阻滞麻醉在痔上黏膜环切术(PPH)中的应用。方法观察分析62例应用肛周神经浸润麻醉并痔上黏膜下肌层阻滞麻醉患者PPH中或术后的不良反应及并发症,并与80例应用单一肛周神经浸润麻醉实施PPH术的患者进行比较。结果两组患者麻醉效果均达到手术要求。两组患者术中下腹牵拉痛、强烈急便感及术后肛门胀痛、下腹痉挛痛、里急后重感等并发症的发生率间差别有显著性意义(P<0.05)。结论肛周神经浸润麻醉实施PPH效果肯定,在此基础上再加用痔上黏膜下肌层阻滞麻醉,可减少术中或术后不良反应及并发症,提高麻醉效果。

Perianal Nerve Infiltration Anesthesia and the Block Anesthesia of Superior Hemorrhoidal Submucous Muscular Layer in Procedure for Prolapse and Hemorrhoids

Objective To evaluate the perianal nerve infiltration anesthesia and the block anesthesia of superior hemorrhoidal submucous muscular layer in procedure for prolapse and hemorrhoids (PPH).Methods The adverse reactions and complications during and after operation of 62 patients who received the perianal nerve infiltration anesthesia and the block anesthesia of superior hemorrhoidal submucous muscular layer in procedure for PPH were observed and analyzed,and compared with those of 80 patients who received sole perianal nerve infiltration anesthesia.Results The results of anesthesia in both groups met the surgical requests.However the adverse reactions and complications in the trial group were obviously less than those in the control group,including hypogastric dragging pain and strong acute feeling of defecation during the operation,and postoperative anal distending pain,cramp pain of lover abdomen and tenesmus,with a significant difference (P<0.05).Conclusion The effect of perianal nerve infiltration anesthesia for PPH is affirmative,and on the this basis,additional the block anesthesia of superior hemorrhoidal submucous muscular layer can reduce the adverse reactions and complications during and after the operation,and raise the effect of anesthesia.