2020年9月7日星期一

hemorrhoids and anal fissures,The painless theory of hemorrhoid surgery

    Speaking of hemorrhoid surgery, many patients couldn't help but tighten the chrysanthemum. There are various rumors about hemorrhoid surgery. Among them, the most widely spread is that the pain after hemorrhoid surgery is unbearable, unable to walk and need to stay in bed for a period of time. These rumors also make some patients with hemorrhoids dare not look directly at the operation and look for various folk remedies.

    So is it painful after hemorrhoid surgery? For the first time we will talk about hemorrhoids from anatomy. There is an anatomical landmark at the anus: the dentate line. Those located above the dentate line are internal hemorrhoids, those located below the dentate line are called external hemorrhoids, and those that straddle the dentate line are called mixed hemorrhoids. Generally speaking, the mucous membrane above the dentate line is not sensitive to pain. If the operation is performed in this range, the patient will feel very light postoperative pain, and the skin below the dentate line is sensitive to pain. Operating in this range is pain sensitive and the patient There may be strong pain after surgery. Secondly, let’s talk about the function of the anus. The anus is used for defecation. Daily defecation activities prevent local tissues from resting. At the same time, the stimulation of feces and other pollutants can also cause anal sphincter spasm and cause unbearable pain.

    So some patients asked, why I walked after your hemorrhoid surgery, and I didn’t feel much pain when I was sitting? Some patients also asked whether the painless claims of some hospitals outside were true. In order to achieve so-called painlessness, medical workers are racking their brains and various methods are emerging one after another. In fact, there is no real painlessness. The so-called painlessness just reduces the postoperative pain to the minimum. We usually interpret the postoperative pain score below 3 as painless, which means that slight pain does not affect sleep. In order to achieve the so-called painless, we should pay attention to the following aspects:

    1. Improvement of surgical methods. At present, various surgical methods such as PPH, RPH, injection, etc. are all performed above the dentate line, which is not sensitive to pain.

    2. Preoperative analgesia. Do a good job of publicity and education before surgery to eliminate patients' doubts about pain. For some particularly sensitive patients, preoperative drug intervention can be used. Some hospitals also use preoperative pudendal nerve block with good results.

    3. Postoperative analgesia on demand. After the operation, it is necessary to change the concept, from "analgesia on demand" to "analgesia on time", multi-modal analgesia, so that the drug concentration of analgesics in the body maintains a peak. The general postoperative analgesia cycle is about 10 days.

    4. Precise surgical operation. Precise surgical operation is the core of painless postoperative hemorrhoids. Reasonable surgical plan, accurate anatomical level, meticulous surgical operation, reduce the side injury caused by the operation. Especially to avoid damage to the anal sphincter.

    Only by accomplishing these points can we achieve the so-called painlessness after hemorrhoid surgery.

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