阴部神经阻滞在痔手术中的应用

目的探讨阴部神经阻滞麻醉在痔切除手术中应用的临床效果。方法对两组各25例Ⅲ、Ⅳ度痔患者分别采用阴部神经阻滞麻醉及腰部麻醉,分别观察比较两组患者手术操作时间,术中麻醉效果,术后第一次疼痛的时间,最大疼痛分级,术后继发出血、尿潴留及恶心、呕吐情况。结果两组患者在手术操作时间及术中麻醉效果的比较上无显著性差异（P〉0.05）;阴部神经阻滞组术后第一次疼痛时间13.53±1.82 h相比腰部麻醉组6.15±2.60 h明显延长（P〈0.05）;阴部神经阻滞组在各时段最大疼痛分级明显优于腰部麻醉组（P〈0.05）;阴部神经阻滞组术后尿潴留及恶心、呕吐发生率比腰部麻醉组明显减少（P〈0.05）。结论阴部神经阻滞麻醉用于痔手术,麻醉效果好,镇痛时间长,降低了常规腰部麻醉带来的痔术后并发症的发生,并为门诊手术开展提供技术支持。

Pudendal nerve block anesthesia in hemorrhoidectomy

Objective To investigate the clinical effect of pudendal nerve block anesthesia in hemorrhoidectomy.Methods Patients with grade III or IV hemorrhoids were divided into group A(25 patients,pudendal nerve block anesthesia) and group B(25 patients,spinal anesthesia).Operation time,intraoperative anesthetic effect,the first pain of postoperative,maximum pain score,urinary retention and nausea and vomiting were observed and compared in the two groups.Results All patients in two groups obtained satisfactory anesthetic effect,there were no significant difference in operation time and anesthetic effect in two groups(P>0.05);there was an obvious longer time of first post operational pain in pudendal nerve block anesthesia group(13.53±1.82h) than that in spinal anesthesia group(6.15±2.60h,P<0.05);maximum pain scale of all period of pudendal nerve block anesthesia was better than that of spinal anesthesia(P<0.05);post operational urinary retention and nausea and vomiting in pudendal nerve block anesthesia group decreased more obviously than that in spinal anesthesia(P<0.05).Conclusion Pudendal nerve block anesthesia is a good kind of anesthesia for hemorrhoidectomy,it can provide longer painless time and also reduce complications,which occur frequently in spinal anesthesia.Pudendal nerve block anesthesia can provide technical support for outpatient surgery.