The Application Of The Fistulotomy Part In High Anal Fistula Treatment

Objective:To observe the anesthetic effects and adverse reactions of low-does bupivacaine in surgical treatment of anal fistula.Methods:The173patients given spinal anesthesia in anal fistula surgery were randomly divided into three groups:group A(n=58)received0.75%bupivacaine1.5ml,group B(n=58) received0.75%bupivacaine1.0ml, group C(n=57)received0.75%bupivacaine0.6ml.To observe and compare the analgesia effects,the differences between anal canal pressure before and after spinal anesthesia,the anal tectum ring afer anesthesia,and the adverse reactions after surgery.Results:There is not significant difference in anlanesic effect among group A,B,C(P>0.05). After spinal anesthesia,the anal canal pressure of group C were higher than group A and B, and the anal tectum ring of group C more palpable.The incidence of urinary retention of group C were significantly lower than group A and group B(P<0.05).Conclusion:By using0.6ml0.75%bupivacaine in spinal anesthesia ,we can acquire the most satisfactory anlagesic effect and the clarity of anal tectum ring in anal fistula surgery, with the lowest incidence of urinary retention.I t also provides with anatomical identifiable basis to avoide the damage of the anus homemade function and thread-drawing blindly. Objective:To investigate the effect of syringotomy in low-dose spinal anaesthesia.Methods:We conducted an unplanned interim analysis of a randomized,multicenter,open-label,noninferiority trial involving60patients with high anal fistula of fistula below anal rectal ring1/2,in which30to receive syringotomy(syringotomy group),and30patients were assigned to receive secton division(control group).Result:Postoperative pain,incidence of urinary retention and wound healing time were highly significantly different in the two groups(P<0.05),but anal pressure,anal homemade function and operative efficacy were no difference(P>0.05).Discussion:The patients with high anal fitulota treated with syringotomy in low-dose spinal anaesthesia will be found the smaller pain,the faster recovery,the lower incidence of urinary retention and the less anus homemade dysfunction.