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Macau Periodical Index (澳門期刊論文索引)
- Author
- Luo, Guang Hui；Lam, Ut Sim；Li, Zhong Hua；Zhong, Shi Zhen；Song, Tao
- Title
- The anatomical basis and clinical application with implementation of anal nerve block anesthesia in PPH surgery
- Journal Name
- 鏡湖醫學
- Pub. Info
- 2016年6月, 總第34期, 第16卷第1期, pp. 18-20
- Link
- http://www.kwh.org.mo/download/med34.pdf
- Keyword
- Local anesthesia；PPH；Complications；Anatomy
- Abstract
- Objective：To investigate PPH of rectal nerve block anesthesia with the implementation of the anatomical basis and clinical application by verified. Methods：Ischioanal fossas of 15 prostrated adult cadaveric specimens (30 sides) were dissected to observe the distance and angle from anal nerves to anus. The adjacent structures of the anal nerves and it’s location point were also be measured. Application the clinical data of the method of location mark the implementation for 51 cases of PPH. Results：The length from 3 o’clock or 9 o’clock position at anus to the trunk of anal nerves was about (4.93±0.91) cm(3.80~7.10cm).The angle of declination to the trunk from both positions was (15.6±3.3)° (15~20°). 51 cases were operated in accordance with the implementation of the location mark to anal nerve block anesthesia，the patient can tolerate surgery stimulate，no additional intraoperative anesthetic and analgesic drugs，no anesthesia accidents，only 5 cases of urinary retention. Conclusion：The position of anal nerves is quite invariable. The trunk of anal nerves locates in the outer 1/3 segment of the line of coccygeal tip to ischial tuberosity and is 2.21cm away from the medial region of ischial tuberosity, it is about 1.36cm in the front of the most bulgy aspect of the ischial tuberosity at the same level. This spot will be a much effective site for block anesthesia and can be implemented for the PPH. Paragraph Headings： 1. Information 1.1. Anatomical information 1.2. Clinical information 1.3. Anesthetic method 2. Result 2.1. Related measurements 2.2. Anesthetic effect 2.3. Post-operative complications 2.4. Operation time and length of hospital stay 3. Discussion 3.1.1. The key points on application of anal nerve block anesthesia 3.1.2. Mild pain throughout the whole process 3.1.3. Economic and simple 3.1.4. Quick recovery 3.1.5. Relaxation on the indications of modified PPH Tables： 1. The distance or angle of the trunk of anal nerves to the concerned structure around Figures： 1. Two branches of anal nerve (1) Anterior branch of anal nerve(2) Posterior branch of anal nerve (3) Coccygeal tip(4) The most prominent point of ischial tuberosity (5)Sacrotuberous ligament 2. The position of anal nerve (1) Coccygeal tip(2) The most prominent point of ischial tuberosity(3) Inferior margin of gluteus maximus(4) Anal nerve (5) Sacrotuberous ligament