持续臂丛神经阻滞复合瑞芬太尼用于断指再植手术的麻醉观察

Clinical oberservation of continuous brachial plexus block combined with remifentanil on replantation of amputated fingers

目的持续臂丛神经阻滞复合瑞芬太尼恒速输注用于断指再植手术的麻醉观察。方法选择40例断指再植手术患者，随机分为两组，Ⅰ组为芬氟合剂组，Ⅱ组为瑞芬太尼组，每组各20例。两组之间年龄、性别、手术种类等差异无统计学意义。Ⅰ组静注芬太尼0．05mg、氟哌利多25mg，有体动反应时再给予芬太尼0．05mg、氟哌利多2．5mg静注，以后每小时推注芬太尼0．05mg。Ⅱ组恒速输注瑞芬太尼0．05μg／（kg·min）直至手术结束。结果芬氟合剂组（Ⅰ组）强化麻醉效果优良率85％，瑞芬太尼组（Ⅱ组）优良率95％，两组比较差异有统计学意义（P〈0．01）。结论持续臂丛神经阻滞复合瑞芬太尼用于断指再植手术强化麻醉效果良好，对呼吸循环无影响，安全可靠。

Objective To oberserve the effect of continuous brachial plexus block combined with remifentanil on replantation of amputated fingers by constant - speed infusion. Methods Forty patients underwent replantation of amputated fingers were randomly divided into two groups, the innovar group （ group Ⅰ ） and remientanil group（ group Ⅱ ）. Age ,sex and surgeries there were no significant difference between the two groups. Fentanyl 0.05 rag, droperidol 2.5 mg were infused in group Ⅰ ,when body motion occurred, fentanyl 0. 05 mg,droperidol 2.5 mg were given again, then fentanyl 0. 05 mg was infused each hour. Remientanil 0.05 μg/（ kg · min） was infused by continuous steady -rate in group Ⅱ until the end of operation. Results The excellent and good rate was 85% in group Ⅰ , that was 95% in group Ⅱ , there was significant difference between the two groups （ P 〈 0.01 ）. Conclusions Continuous braehial plexus block combined with remifentanil on replantation of amputated fingers is effective and safty, it has no influence on respiration ,circulation system.