| Objective:At present,procedure for prolapse and hemorrhoids(PPH),a kind of minimally invasive treatment,is more and more adopted on the internal hemorrhoids and combined hemorroid on the degree of Ⅲ and Ⅳ.PPH surgery can realize the one-time excision of mucous membrane of rectum,and the stapling of mucosal remnants with titanium nails,at the same time.This treatment is a more reliable and efficient mode of operation,with thoroughgoing excision,less bleeding,faster postoperative recovery,better prognosis,and better acceptability,which is becoming more and more widely applied.When pulling on the trigger,in the PPH operation,there will be an obvious rectal traction response,therefore,the operation requires a certain "quality" and "quantity" of the sacral anesthesia.The concentration of anesthetic agents in the sacral administration determines the "quality" of anesthetic effect.But,if the concentration is too high,which will prolong the recovery time of anesthesia and increase the probability of urinary retention.In this paper,three kinds of local anesthetics are used to evaluate the advantages and disadvantages of the three schemes.Methods:At first,we selected 500 patients randomly,who will accept PPH operation in the sacral canal anesthesia.And then we applied five kinds of local anesthetic formula to each 100 patients,which are low,medium and high concentrations of ropivacaine-lidocaine and two control groups of pure lidocaine hydrochloride and ropivacaine,meanwhile,monitoring vital signs,recording the effecting time and maintenance time,evaluating the effects of anesthesia,recording the untoward effect and post-operative uroschesis.At last,we counted and analyzed all the data.Results:According to these data,anesthesia effect time,anesthetic effect,the comparison of maximum degree of motor block,anesthetic accident,of the five groups of different drug compatibility,with P>0.05,have no statistical significance.Different concentrations of ropivacaine,have nearly anesthesia effect.There groups of medium and highconcentrations of ropivacaine – lidocaine and pure ropivacaine have less cases among the rectal traction reaction.After the operation,the patients in the lower and middle concentration groups obtained a better recovery of urination function.Therefore,the medium concentration group,can achieve effective analgesic effect and satisfy the demands of surgery anesthesia,also,have less frequent rectum retraction of the reaction,faster urination function recovery and lower incidence of urinary retention.Avoiding postoperative urethral catheterization,the patients feel better.Conclusion:Among the five different concentrations of anesthetic agents,the middle concentration group is more suitable for the operation of PPH,which is more befitting for clinical application. |
