| OBJECTIVE: 1.To explore the clinical feasibility of the walkable spinal anesthesia technique 2.To explore whether this technique can improve postoperative complications of anorectal surgery and promote early recovery of patientsMETHODS: A total of 84 cases of eligible patients who were to undergo anorectal surgery at the Affiliated Hospital of Yan’an University from April 2022 to February2023 were included,one case with an operation duration of more than 30 minutes was excluded,and one case with a change in anesthesia method was excluded.82 cases were finally included in the study,and they were randomly assigned into control group C(7.5mg bupivacaine dose)and experimental group S(3 mg bupivacaine dose),with 41 cases in each group.The proportion of patients who could walk after surgery,the proportion of patients who crossed the bed by themselves after surgery,the recovery of motor function and gastrointestinal function after surgery,postoperative analgesia,the incidence of complications and the number of days of hospitalization were observed.RESULTS: The percentage of ambulation after surgery was significantly higher in group C(0)and group S(90.24%)than group C.The difference was statistically significant at the level of P<0.001.The proportion of self-crossing the bed after surgery: group C(0),group S(100%)was also significantly higher than group C,with a statistically significant difference.Intraoperative anesthesia effect: there was no significant difference between the two groups.Anesthesia onset time: [2/(1,2)min] in group C and [2/(1,2)min] in group S.Incidence of intraoperative pulling reaction:group C(0),group S(2.44%).Recovery of postoperative motor function: time to first postoperative bed activity,group C [6.5/(6.1,7.0)h],group S [4.8/(2.5,6.1)h],statistically significant at the P<0.001 level;time to muscle strength level 5,group C[4/(3.8,5.0)h],group S [1.0/(0.8,1.6)h],statistically significant at the P< 0.001 level was a highly significant statistical difference.Postoperative gastrointestinal recovery:the amount of water consumed within 6 h after surgery was [0/(0,50)ml] in group C[50/(50,100)ml] and [50/(50,100)ml] in group S.There was a statistically significant difference at the P<0.001 level;the recovery time of voluntary urination after surgery was [7.1/(6.3,8.9)h] in group C [4.8/(3.0,6.95)h] and [4.8/(3.0,6.95)h] in group S.The difference was statistically significant at the P<0.01 level.statistically significant;time to first venting,group C(17.29±5.59h),group S(17.05±4.74h),no statistically significant difference.Postoperative analgesia: the total number of times ketocromic aminotriol was administered at each postoperative time point T1,T2,T3,T4,T5,and T6 in both groups: group C(5 ± 5 times)versus group S(6 ± 6 times),P > 0.05,no statistically significant difference when compared.Postoperative complication rate:difficulty in urination,group C(56.10%)versus group S(7.32%),statistically significant difference at P<0.001 level;other complications,no statistically significant difference between the two groups.Hospitalization days: group C(8(8/10)days),group S(8(7/9)days),the difference was statistically significant at the P<0.05 level,and the length of stay was shorter in group S.Conclusion: Walkable spinal anesthesia(3 mg dose)can meet the requirements of intraoperative anesthesia and achieve early recovery from motor block,while reducing the complication rate and shortening the hospital stay,and is feasible for clinical application in anorectal surgery. |
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