ALCOCK 管超声引导下的耻骨内神经阻滞在术后肛门镇痛中的应用

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A total of 134 patients who underwent anal surgery in Hangzhou Lin'an District First People's Hospital from May, 2021 to July, 2022 were divided into three categories according to mixed hemorrhoids, anal fistula, and anal fissure and randomly divided into control and experimental groups. The two groups were treated with corresponding surgical treatment, and the experimental group was treated with bilateral pudendal nerve block under the guidance of ALCOCK tube ultrasound at the end of the operation. The operation time, blood loss, initial postoperative pain time, and visual analogue scale, postoperative pain score at each time point, incidence of complications, and patient satisfaction were recorded and analyzed. Results: The operation time of the experimental group was significantly longer than that of the control group, the bleeding volume of anal fistula in the experimental group was more than the control group, the first pain time of anal fistula in the experimental group was higher than that of the control group. The first pain score of anal fistula in the experimental group was lower than that of the control group. Follow-up showed that the pain scores of anal fistula and anal fissure groups were inconsistent 48 h after surgery. The total incidence of adverse reactions was lower, and the patient satisfaction was higher in the experimental group than in the control group. 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The two groups were treated with corresponding surgical treatment, and the experimental group was treated with bilateral pudendal nerve block under the guidance of ALCOCK tube ultrasound at the end of the operation. The operation time, blood loss, initial postoperative pain time, and visual analogue scale, postoperative pain score at each time point, incidence of complications, and patient satisfaction were recorded and analyzed. Results: The operation time of the experimental group was significantly longer than that of the control group, the bleeding volume of anal fistula in the experimental group was more than the control group, the first pain time of anal fistula in the experimental group was higher than that of the control group. The first pain score of anal fistula in the experimental group was lower than that of the control group. Follow-up showed that the pain scores of anal fistula and anal fissure groups were inconsistent 48 h after surgery. 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引用次数: 0

摘要

背景:手术是治疗肛肠疾病最有效的方法,但传统的麻醉方法越来越被认为不适合肛肠患者的临床需要。虽然阴部神经阻滞能在肛门区域发挥良好的镇痛作用,但传统的阴部神经阻滞是在盲探的情况下进行的,定位不准确,麻醉效果差,并发症多。 研究目的目前,临床上出现了超声引导下的阴部神经阻滞镇痛。因此,本研究旨在探讨 ALCOCK 管超声引导下的阴茎内神经阻滞在肛门手术中的镇痛效果。 研究方法采用前瞻性研究方法。将 2021 年 5 月至 2022 年 7 月在杭州市临安区第一人民医院接受肛肠手术的 134 例患者按照混合痔、肛瘘、肛裂分为三类,随机分为对照组和实验组。两组均采用相应的手术治疗,实验组手术结束后在ALCOCK管超声引导下行双侧阴部神经阻滞治疗。记录并分析手术时间、失血量、术后初始疼痛时间以及各时间点的视觉模拟量表、术后疼痛评分、并发症发生率和患者满意度。 结果实验组手术时间明显长于对照组,实验组肛瘘出血量多于对照组,实验组肛瘘首次疼痛时间高于对照组。实验组肛瘘首次疼痛评分低于对照组。随访显示,肛瘘组和肛裂组术后 48 h 的疼痛评分不一致。实验组不良反应总发生率低于对照组,患者满意度高于对照组。 结论在ALCOCK管超声引导下应用阴茎内神经阻滞治疗肛肠手术,镇痛效果好,患者满意度高,值得推广。
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Application of ALCOCK Tube Ultrasound-guided Internal Pudendal Nerve Block in Postoperative Anal Analgesia
Background: While surgery is the most effective treatment for anorectal diseases, traditional anesthesia methods are increasingly regarded not suitable for the clinical needs of anorectal patients. Although pudendal nerve block can play a good analgesic role in the anal region, the traditional pudendal nerve block is performed under blind probing, which is inaccurate in positioning, has poor anesthesia effect, and causes many complications. Objectives: At present, ultrasound-guided pudendal nerve block for analgesia has emerged in clinical practice. Therefore, the present study aimed to investigate the analgesic effect of ALCOCK tube ultrasound-guided internal pudendal nerve block in anal surgery. Methods: A prospective study was conducted. A total of 134 patients who underwent anal surgery in Hangzhou Lin'an District First People's Hospital from May, 2021 to July, 2022 were divided into three categories according to mixed hemorrhoids, anal fistula, and anal fissure and randomly divided into control and experimental groups. The two groups were treated with corresponding surgical treatment, and the experimental group was treated with bilateral pudendal nerve block under the guidance of ALCOCK tube ultrasound at the end of the operation. The operation time, blood loss, initial postoperative pain time, and visual analogue scale, postoperative pain score at each time point, incidence of complications, and patient satisfaction were recorded and analyzed. Results: The operation time of the experimental group was significantly longer than that of the control group, the bleeding volume of anal fistula in the experimental group was more than the control group, the first pain time of anal fistula in the experimental group was higher than that of the control group. The first pain score of anal fistula in the experimental group was lower than that of the control group. Follow-up showed that the pain scores of anal fistula and anal fissure groups were inconsistent 48 h after surgery. The total incidence of adverse reactions was lower, and the patient satisfaction was higher in the experimental group than in the control group. Conclusion: The application of internal pudendal nerve block under the guidance of ALCOCK tube ultrasound in anal surgery has a good analgesic effect and high patient satisfaction, which is worthy of promotion.
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Iranian Red Crescent Medical Journal
Iranian Red Crescent Medical Journal 医学-医学:内科
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期刊介绍: The IRANIAN RED CRESCENT MEDICAL JOURNAL is an international, English language, peer-reviewed journal dealing with general Medicine and Surgery, Disaster Medicine and Health Policy. It is an official Journal of the Iranian Hospital Dubai and is published monthly. The Iranian Red Crescent Medical Journal aims at publishing the high quality materials, both clinical and scientific, on all aspects of Medicine and Surgery
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