Application Of Postoperative Analgesia With Lomoxicam After Digital Replantation Surgery

Objective： To observe the effects of postoperative analgesia withlornoxicam after digital replantation surgery on stress response and vasospasmcorrelation factors.Methods：40patients with emergency operation of digital replantationwere divided randomly into lornoxicam group （group A,20cases,39fingers）and control group （group B,20cases,40fingers）. Anesthesia method wassingle brachial plexus block. Lornoxicam8mg was used in group A during theoperation, and additional8mg was given at the end of the operation. Thecontrol group were given0.9%sodium chloride injection2ml at that timepoints. Detected glucose （Glu）, cortisol （Cor）, angiotensin II （AngII）,norepinephrine （E） before anesthesia （T₁）, at the end of operation （T₂）,3h （T₃）,12（T₄） and24h （T₅） after operation. Recorded the dosage of pethidine. After0,4,8,12,24,36,48h takes a visual analogue scale （VAS method） was taken forpain assessment. Recorded the dosage of papaverine, vascular crisis rate andsurvival rate of replanted fingers.Results：The glucose in both group A and group B was increased at theend of the operation （T₂） compared with those before operation. Glucose incontrol group was significantly higher than that in lornoxicam group, P <0.05.Cortisol in A group was significantly lower than that in B group at the end ofthe operation （T₂） and3h after operation （T₃）, P <0.05. Angiotensin II andnorepinephrine in group A were lower than that in group B at T₂, T₃and T₄, P <0.05.4h,8h,12h,24h after operation, the VAS score in group A were less thanthat in group B. Pethidine dosage was lower in group A than that in group B （P<0.05）. The dosage of papaverine was lower in group A than that in group B. Conclusions：Lornoxicam used in postoperative analgesia of patients withfinger replantation can effectively restrain the stress caused by trauma andoperation, reduce the dosage of papaverine, and relieve the vasospasm causedby pain, contributed to the survival of replanted fingers.