Effects of dexamethasone combined with ropivacaine incision infiltration on pain and wound healing after complex anal fistula surgery

Objective: To explore the effects of dexamethasone combined with ropivacaine incision infiltration on pain and wound healing after complex anal fistula surgery.Methods: A total of 120 patients with complex anal fistula surgery were collected and randomly divided into control group,ropivacaine group,and combination group,with 40 patients in each group.All patients were treated by directional thread-drawing procedure.Before surgery,the patients were anesthetized by ropivacaine via spinal anesthesia.During or post-surgery,the incisions were infiltration with dexamethasone combined with ropivacaine in the combination group,the incisions were infiltration with ropivacaine in the ropivacaine group,and the incision of the control group was not treated.The pain,exudation and wound healing time after operation were compared among the three groups.Besides,the rats with anal fistula were randomly divided into control group,ropivacaine group,and combination group.The medication and treatment during and postoperation were the same as those of the patients.The wound tissues were collected 7 days after surgery.Western blotting was used to measure the protein expressions of VEGF and bFGF.Histopathology was used to analyze the inflammatory cell infiltration.qPCR was used to detect the mRNA expressions of IL-1β,IL-6 and TNF-α.Results: At 3,7 and 14 day after surgery,the pain and seepage grades in patients of the ropivacaine group and combination group were significantly better than those of the control group,and the patients in the combination group were also significantly better than those in the ropivacaine group (P<0.01).Animal experiment results showed that,compared to the control group,the protein expressions of VEGF and bFGF in wound tissues in the ropivacaine group and combination group increased significantly,and the inflammatory cells and the mRNA expressions of IL-1β,IL-6 and TNF-α in the ropivacaine group and combination group decreased significantly (P<0.01).Meanwhile,the wound healing rate and protein expression of VEGF and bFGF in the combination group were higher than those in the ropivacaine group,the IL-1β,IL-6,TNF-α MRNA expression was significantly lower than that of ropivacaine group (P<0.01).Conclusions: Dexamethasone combined with ropivacaine incision infiltration significantly attenuates pain and promotes wound healing in patients after complex anal fistula surgery.Animal experiments have reached the same conclusion,which provides a basis for clinical application.