瑞芬太尼对断指再植手术止血带痛的临床价值

Clinical Value of Remifentanil on Tourniquet Pain in Replantation of Severed Fingers

目的在臂丛神经阻滞麻醉下断指再植手术止血带痛的防治中应用不同靶控浓度瑞芬太尼后的作用进行分析。方法选取2018年8月—2020年7月来我院就诊的断指再植手术患者90例随机分为三组,分别于臂丛神经阻滞麻醉前5 min输注4µg/mL(A组)、6µg/mL(B组)的瑞芬太尼及等量生理盐水(C组),对比分析三组患者的临床效果。结果相比C组,A、B两组患者的平均动脉压、心率和疼痛程度均有所改善;且随着瑞芬太尼靶控浓度的升高Ramsay镇静评分增加,术中止血带痛发生率降低,组间差异具有统计学意义(P<0.05)。结论在臂丛神经阻滞麻醉下断指再植手术止血带痛的防治中应用4µg/mL、6µg/mL靶控浓度瑞芬太尼均具有一定的价值,需要根据患者的实际情况选择合理的靶控浓度,以提高患者的临床整体效果。

Objective To analyze the effect of different target controlled concentrations of remifentanil in the prevention and treatment of tourniquet pain in finger replantation under brachial plexus block anesthesia.Methods 90 patients with replantation of severed fingers from August 2018 to July 2020 in our hospital were randomly divided into three groups.Remifentanil of 4μg/mL(group A),6μg/mL(group B)and equal volume of normal saline(Group C)were infused 5 minutes before brachial plexus block anesthesia.Results Compared with group C,the average arterial pressure,heart rate and pain degree of group A and B were improved;and with the increase of remifentanil target controlled concentration,Ramsay Sedation score increased,and the incidence of tourniquet pain decreased,the difference between groups was statistically significant(P<0.05).Conclusion In the prevention and treatment of tourniquet pain in replantation of severed fingers under brachial plexus block anesthesia,the application of target controlled concentration of remifentanil with 4μg/mL and 6μg/mL has certain value.It is necessary to select reasonable target controlled concentration according to the actual situation of patients,so as to improve the overall clinical effect of patients.