A Clinical Observation Of Dexmedetomidine Used In Finger Replantation Patients

Background:The sedation of non-general anesthesia intraoperative and postoperative can reducethe nervousness and anxiety of patients,and the usual intravenous agent is propofol.Butpropofol has big influence on hemodynamics and inhabits the respiration.Dexmedetomidine is a new α-2receptor agonist which can inhabit sympathetic nerveand usually used in the operation. But it has little use in finger replantation with localanesthetic of brachial plexus block.Objective:We would plan to explore the effects of continuous usage of dexmedetomidine onfinger replantation patients intraoperative and postoperative with local anesthetic ofbrachial plexus block. And observe the changes of heart rate, oxygen saturation, bloodpressure, blood glucose, stress hormones including cortisol, angiotensin II, epinephrineand norepinephrine,and inflammatory factors such as IL-1, IL-10and TNF-α. Toevaluate changes of stress response and hemodynamics with this sedation method andmake sure if it can improve the survival rate of finger replantationMethod:30patients with ASA1or2grade scheduled for finger replantation were randomlydivided into dexmedetomidine group(A group), propofol group(B group) and controlgroup(C group). All the patients were performed by local anesthetic of brachial plexusblock. Heart rate, oxygen saturation, blood pressure, blood glucose, plasmaconcentrations of cortisol, angiotensin II, epinephrine, norepinephrine, IL-1, IL-10andTNF-α were measured before anesthesia, first hour,4hours,8hours,12hours and24hours after operation in all groups.Results:There was no significant difference of all marks before operation in all groups.Dexmedetomidine group and propofol group have significantly lower plasma stress hormones and than the control group. The concentration of TNF-αand IL-1indexmedetomidine group is significantly lower than the control group, and IL-10issignificantly higher than the control group.The hemodynamics in dexmedetomidinegroup is more stable than propofol group and control group.Conclusion:Dexmedetomidine can make the hemodynamics stable， have a certain role inpromoting the recovery after replantation of severed finger with few adverse reactions inthe finger replantation patients. Also, it can inhabit the stress response and the release ofinflammatory factor similarly to propofol.