The Effect Of Dexmedetomidine Combined With Ropivacaine Axillary Brachial Plexus Block On Ischemia-reperfusion Injury Of Replantation Of Severed Finger

Objective To observe the effect of dexmedetomidine combined with ropivacaine on the postoperative effect of axillary brachial plexus block on replantation of severed fingers,and to detect the plasma of malondialdehyde MDA and superoxide dismutase SOD in the replantation patients' peripheral blood.To investigate whether combination of dexmedetomidine and ropivacaine in peripheral nerve block can reduce ischemia-reperfusion injury after replantation of severed fingers.Methods 60 patients with ASA I~II undergoing emergency diagnosis of replantation,randomly divided into A and B groups,30 cases of each group,all patients underwent ultrasound guided axillary brachial plexus block anesthesia.Group A: 0.375% ropivacaine 35 ml for axillary brachial plexus block;Group B: 35 ml 0.375% ropivacaine with 0.5?g/Kg dexmedetomidine.The onset time of sensory and motor block and recovery time of postoperative sensory and motion were recorded.The NRS analgesia score and Ramsay sedation score were recorded at the beginning of anesthesia(T0)?the end of operation(T1)?4 hours after operation(T2)?12 hours after operation(T3)and 24 hours after operation(T4)in both groups.At the same time,the antrum blood of the affected side was collected at T0?T1?T2?T3 and T4;the SOD concentration was measured;thiobarbituric acid method(TBA)determination of MDA concentration.Results 1.There was no significant difference in the onset time of sensory nerve block between the two groups(P>0.05).There was a significant difference in the onset time of motor nerve block between the two groups(P<0.05).2.There was a significant difference in the duration of postoperative sensory and motor block between the two groups(P<0.05).3.There was no statistically significant difference between the two groups of patients at the beginning of anesthesia,at the end of the operation,and 2h NRS after surgery(P>0.05),and the postoperative pain scores of 4h,12 h and 24 h NRS were statistically significant(P<0.05).4.There was no significant difference in Ramsay sedation score between the two groups at the beginning of anesthesia(P>0.05).Ramsay sedation score in group B was higher than that in group A at the end of surgery,2h,4h,12 h,and 24 h after operation.5.There was no significant difference in serum MDA and SOD between the two groups at T0 and T1(P>0.05).There was a significant difference in serum MDA and SOD at T2,T3 and T4(P<0.05).At the time of T2,T3 and T4,MDA in group B was lower than that in group A,and the difference was statistically significant(P<0.05).The SOD of group B was higher than that in group A,and the difference was statistically significant(P<0.05).Conclusion 1.Dexmedetomidine combined with ropivacaine for brachial plexus block can shorten the onset time of motor block,significantly prolong the sensory and motor block time..2.Dexmedetomidine combined with ropivacaine for axillary brachial plexus block can reduce the ischemia-reperfusion injury of severed finger replantation.