Rule Of Time Sequence Of Postoperative Pain Of Milligan-Morgan Hemorrhoidectomy In Patients With Hemorrhoids Due To Downward Flow Of Damp-heat Pathogen

Objective: Hemorrhoids is one of the most common disease of clinic. Surgical interventionis the main treatment of choice for theⅢ,Ⅳ-degree hemorrhoids. The Milligan-Morganhemorrhoidectomy is the most popular surgery for hemorrhoids. Because of the particularanatomy of anus, postoperative pain is often terrible, and the pain may come as a chiefpostoperative complication, which would delay the time to recover to work or have animpact on the quality of life. Presently, little has been reported about the characters of thepostoperative pain after Milligan-Morgan hemorrhoidectomy.Nor the appropriate time isknown when the analgesias should be applied for relieving the postoperative pain.Our workwas performed to solve the problem.Methods: The study included 120 patients undergoing Milligan-Morgan hemorrhoidectomybetween Aug. 2006 and Feb. 2007.The patients were observed postoperatively within aperiod of 7 days with the following data record:①the time of the pain and its character;②the time of the first urination;③the time of the first defecation and the consistency of stools;daily frequency ofdefecation;④the time and frequency of the administration of analgesia(Tramadol injection 0.1g i.m.)and the time when the pain was relieved;⑤the daily change of the edema at the wound;⑥the sleeping soundness;⑦the time of dropping of the last hemorrhoid;⑧the occurrence of any anal spastic pain.All data were analyzed by SPSS 13.0. Results: Most patients felt painful at 2nd～4th hour after the operation, with their painsincreasing between the 4th～6th hour and reading the peak at 6～10 hourspostoperatively.And the persistence time after reading the peak of the postoperative painwas 2～5 hours. The across of the postoperative pain was directly proportional to thenumber of the incision in the operation(P＜0.05). The ability to urinate by the patienthimself depended also on the number of the incision (P＜0.05).Most of the pain was able tobe relieved with 0.5 hour with the effect maintained for 2 hours.The consistency of stoolswas the relate to both the time consumed and the one elapsing between the operation andthe defecation(P＜0.05).The consistency of stools could also have an effect on the characterof the pain(P＜0.05),which usually exaggerated three days after the operation.the averagedopping-off time of the last hemorrhoid was 5.33±1.46519 days.The extent of edema wasdirectly related to the number of the incision.Conclusion: A rule of time sequence existed of the anal pain after the Milligan-Morganhemorrhoidectomy for patients with mixed hemorrhoids due to following down ofdamp-heat pathogen.The character of the pain was also related to some extent to suchfactors as urine retention.The number of the incision and the time elapsing between theoperation and the first postoperation urination.