Pain is a common problem after surgery for all end-rectal diseases, as long as there is a surgical operation under the dentate line, there will be pain, therefore, mixed hemorrhoids must be included. The pain after mixed hemorrhoid surgery is described by some of our clinical friends, especially women, who say, “Oh, it hurts more than when I had a baby. There is a classic language description: “The pain in the anus is called the first pain in the world”. This is also the reason why many young and talented people with hemorrhoids are discouraged from having mixed hemorrhoid surgery, leading to the aggravation of their condition. So, is it true that the post-operative pain of mixed hemorrhoids is such a horror? Let’s understand some of the content and then draw conclusions. 1, the causes of pain The human anus area is richer in nerves, for the somatic nerves, pain is very sensitive. However, there are many causes of pain, for example, the site of surgery, the size of the trauma area, the patient’s tolerance level of pain, the patient’s mental condition, the effect of anesthesia, etc. All these factors will affect the degree of pain singly or in a compound way. Pain is usually evident within 24 or 48 hours after surgery. Nerve innervation: the somatic nerve innervation below the dentate line is very sensitive, so surgery can stimulate the nerve and cause pain; surgical operation When dealing with external hemorrhoids, stimulation of the nerve can cause pain, and there is some trauma to the structure of the dentate line when clamping the hemorrhoid nucleus and ligature, and the design and amount of incision can cause local bruising, edema, etc., which leads to spasmodic pain, which is usually obvious in the dead of night, with involuntary contraction pain. However, friends please note that this is a normal phenomenon, no need to panic. In addition, during the surgery, avoid trimming the perianal skin too much to meet the patient’s pursuit of perfection or the operator’s excessive pursuit of perfection, resulting in anal skin defects or even stenosis. Here also remind friends: mixed hemorrhoid surgery, the main solution is the symptoms, to ensure the defecation function, please do not blindly pursue anal flattening and ignore the most important defecation anal function. Anesthesia : The effect of different anesthesia is different, and the good or bad anesthesia effect has a certain influence on the degree of postoperative pain occurrence. However, the choice of anesthesia in clinical practice is the result of a comprehensive consideration of the situation, and the choice of anesthesia should not be made for the sake of reducing pain. We hope patients will understand. Generally, sacral canal anesthesia (lumbar point anesthesia) is sufficient for traditional surgery, and intravenous anesthesia is required for PPH and TST. Postoperative incision infection, anal skin edema, constipation, and suture irritation can cause pain. Fear of psychology : Everyone has a different threshold for pain, and fear of psychology, combined with the stimulation of surgery, which leaves the anal canal in a contracted state for a long time, is bound to intensify the pain. Defecation: After the operation, we will let our patients eat liquid food and encourage them to defecate on the second day after the operation. Good defecation can be of great help to relieve pain, and if constipation and diarrhea occur during the postoperative recovery process, it may cause or aggravate pain. 2.Prevention and treatment For postoperative pain, our principle is still prevention is more important than treatment, and prevention and treatment are combined. Before the operation, patients should relax their ideological baggage, give themselves encouragement, and actively cooperate with the medical staff; the operator should operate finely and accurately, try to avoid unnecessary operations, reasonably design the incision, make linear buttresses, and reduce stitches; after the operation, eat, move around and defecate, and change medication according to the doctor’s prescription; ask your friends to eat normally when they must eat normally, and a long-term liquid diet is not conducive to the recovery of intestinal function, and ask you to eat normally You are required to eat normally because we have many years of experience to verify that there is some truth to it. It is necessary to take appropriate oral bowel medication, which you can adjust as appropriate; you should relax your anus when changing medication, and there is usually little pain associated with changing medication for mixed hemorrhoids. Patients who do have unbearable pain after surgery should communicate with their health care provider about the postoperative management of pain. Either oral, intramuscular, or sedative medication. At present, the concept related to painless surgery has been proposed internationally, and we are groping forward. In fact, there was no severe pain after the mixed hemorrhoid surgery, which is more obvious with the level of the surgeon, the severity of the patient’s mixed hemorrhoids, and their own tolerance. I believe that women are stronger than men as a whole, especially after giving birth, and perhaps this is the greatness of motherhood.