The Study On Applied Anatomy Of The Waist-shu Point And Anesthesia Of Acupoint-injection By Compound Lidocaine Hydrochlotide In Anorectal Operation

Objective:Through the acupoint of YaoShu partial anatomical studies provide evidence for the anatomical level of anesthesia practice the acupoint of YaoShu. With anorectal surgery commonly used two kinds of narcotic drugs-compound lidocaine hydrochloride and lidocaine hydrochloride lumbar anesthesia of shenshu point line, discusses the two drugs in clinical in their respective advantages and disadvantages, to guide the clinical anesthesia drug of choice.Method:Part I:For20adult cadavers (11male and female9) complete sacral anatomy layer by layer, to observe the internal structuring the acupoint of YaoShu, the local structure adjacent to the organizational structure and its relationship to be recorded and analyzed. Part II:Sixty patients needed anorectal surgery,30cases were randomly divided into experimental group and control group30cases. Test group using compound lidocaine hydrochloride injection+5ml water for injection shu lumbar anesthesia; Control group using15ml lidocaine hydrochloride injection+5ml water for injection local anesthesia. Surgery patients were observed adverse reactions in anesthesia, onset and duration of anesthesia, surgery anal relaxation degree, whether an additional anesthetic surgery, intraoperative and postoperative pain in patients, postoperative edema and urinary retention anal margin, the record of the set of data and statistical analysis to explore the advantages and disadvantages of two kinds of anesthesia.Results:Part I:After eight adult cadavers sacral anatomy layer by layer, in order to remove the skin, subcutaneous adipose tissue, muscle, fascia and dorsal sacrococcygeal ligament, seen in the sacral hiatus has layer film, film below (《YAO SHU XUE)) waist Yu hole location) visible layer of yellow fat tissue close to the anterior sacral hiatus and sacral nerves, vertebral end wire and a large parcel of which the venous plexus, and through a lot of connective tissue fibers tightly connected and fixed to the front of the sacral hiatus wall. Part Ⅱ:Compound Menthol back shu points anesthesia compared with lidocaine local anesthesia, anesthesia duration, anal muscle relaxant condition, intraoperative pain, postoperative pain, postoperative urinary retention were statistically different (P<0.05), there statistical significance; The onset time, an additional amount of anesthetic and postoperative anal margin edema was no significant difference (P>0.05), no statistically significant.Conclusion:Part Ⅰ:Beneath the thick and leathery dorsal sacrococcygeal ligament affixed a transparent film, the next film close to the connective tissue layer of yellow, the sacral nerves, vertebral end wire and a large parcel of which the venous plexus and fixed anterior sacral hiatus; The acupoint of YaoShu on anatomical level of anesthesia is injected local anesthetic yellow fatty tissue under the sacrococcygeal ligament, suggesting that it produces a sense of soreness is not yellow or adipose tissue adjacent to the connective tissue wrapped fascia related. Part Ⅱ:Controlled by the test group and the control group was observed two clinical cases, suggesting that compound menthol back shu points compared with compound lidocaine hydrochloride compared to the conventional lidocaine hydrochloride have an advantage.