| Objective:Pain is a common postoperative complication of mixed hemorrhoids,and at the same time,postoperative pain can induce inflammatory edema and delay healing,becoming a common reason for delayed discharge after anorectal surgery.At present,the clinical efficacy of conventional modalities such as pharmacological analgesia and suppository anal plugging are not satisfactory.In this study,we investigated the clinical efficacy and safety of preemptive analgesia for patients with mixed hemorrhoids with butorphanol.In order to provide a new method and basis for the treatment of postoperative pain in hemorrhoids.Methods:Adopt prospective,randomized,controlled,double-blind clinical research design.Select those admitted to the Anorectal Department of the Affiliated Hospital of North Sichuan Medical College from April 1,2020 to January 31,2021 that meet the inclusion criteria.Of the 60 patients with mixed hemorrhoids,33 were males and 27 were females.Using the random number table method,they were randomly divided into A(preemptive analgesia group)and B(postoperative analgesia group)with 30 cases in each group.All patients signed an informed consent form and passed the review of the ethics committee of our hospital.Both groups of patients underwent auto Elastic Thread Ligator For Hemorrhoids(RPH)+external hemorrhoidec tomy under Yaoshu acupoint anesthesia.Group A received intravenous injection of parecoxib before surgery for preemptive analgesia,and group B received intravenous injection of parecoxib immediately after surgery.Observe the patient’s pain within 24 hours after surgery and use the visual analogue scoring method to record the strongest pain within 24 hours.At the same time,record their sleep time,additional pain medication,urination and adverse reactions within 24 hours.Finally,statistical software SPSS 22.0 was used to analyze all data and results.Results:There were no statistically significant differences between the two groups in terms of age distribution,gender differences,length of disease,internal hemorrhoid gradation,external hemorrhoid type and other basic data(P>0.05),which were comparable.Comparison of experimental results(1)Comparison of the visual analogue score of the strongest pain in the two groups after 24 hours and the time to the onset of pain.At the inspection level of a=0.05,the difference in curative effect is significant(P<0.05),which is statistically significant Compared with group B,the strongest pain in group A was lower in 24 hours,and the pain occurred later.(2)In terms of additional analgesic drugs in the two groups,at the inspection level of a=0.05,the difference in additional drugs was significant(P<0.05),which was statistically significant.The number of additional drugs in group A was higher than that in group B within 24 hours.less.(3)The differences were also statistically significant(P<0.05)when comparing the two groups in terms of postoperative sleep time,postoperative urination,and hospital stay,with group A having a longer sleep time,better urination,and shorter hospital stay compared to group B.(4)There was no statistically significant difference between the two groups in terms of satisfaction with postoperative trauma edema and pain control(P>0.05),but patients in group A were more satisfied.(5)No serious adverse reactions occurred in either group.Conclusion:Preoperative parecoxib and postoperative parecoxib are evenly effective in relieving postoperative pain in mixed hemorrhoids,but preemptive analgesia is more effective in relieving pain,reducing the use of analgesic drugs,prolonging patient sleep time,relieving postoperative urinary retention,shortening hospital stay,improving patient satisfaction and being safe without adverse effects,and is an ideal treatment for postoperative pain in mixed hemorrhoids.It is an ideal treatment for postoperative pain management of mixed hemorrhoids and is worthy of clinical application. |
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