摘要
Abstract
Objective To evaluate the efficacy of postoperative patient controlled intravenous analgesia (PCIA) with dexmedetomidine combined with sufentanil in patients undergoing finger replantation.Methods 120 patients undergoing finger replantation in our hospital from January 2017 to January 2018 were randomly divided into control group (60 cases) and observation group (60 cases).The brachial plexus nerve block was induced by high frequency ultrasound in both groups.The PCIA formulation in the control group was 2 μg/kg sufentanil in 100 ml normal saline,and the PCIA formulation in the observation group was 2 μg/kg sufentanil and 2 μg/kg dexmedetomidine in 100 ml normal saline.All patients received PCIA after operation with the background infusion rate 2 ml/h,the bolus infusion rate 0.5 ml/time,and lockout time 15 minutes.VAS score,Ramsay sedation score at 4,12,24,48 h after surgery,the number of PCA key presses,sufentanil dosage,and the adverse effects were recorded.Results VAS scores of the observation group at 4 h,12 h,24 h,and 48 h after surgery were (3.5±1.4),(4.0±1.5),(3.2±0.3),and (2.5±0.7),respectively,the corresponding VAS scores of the control group were (4.7±1.8),(5.1±1.7),(4.9±1.4),and (3.8±1.1),respectively,and there were statistically significant differences between the two groups (P＜0.05).Ramsay scores in the observation group at 4 h,12 h,24 h,and 48 h after surgery were (2.6±0.4),(3.1±1.4),(2.9±0.5),and (3.6±0.3),the corresponding Ramsay scores in the control group were (2.2±0.7),(2.4± 1.1),(2.7±0.2),and (3.2±0.8),respectively,and there were statistically significant differences between the two groups (P＜0.05).The number of PCA key presses [(20.6±5.4) times] and sufentanil dosage [(81.75±21.69) μg] in the observation group were significantly lower than those in the control group [(26.3±4.7),(101.22±20.38) μg] (P＜0.01).The total incidence of nausea and vomiting,dizziness,itching,and other adverse reactions in the observation group (6.7％) was significantly lower than that in the control group (20％) (P＜0.05).Conclusion PCIA with dexmedetomidine combined with sufentanil is effective for patients undergoing finger replantation,which can decrease the incidence of adverse events.关键词
右美托咪定/断指再植术/自控镇痛/舒芬太尼Key words
Dexmedetomidine/Finger replantation/Patient controlled intravenous analgesia (PCIA)/Sufentanil
