Effects Of Ropivacaine Combined With Dexmedetomidine On Myocardial Stress During Perioperative Ischemia Reperfusion During Replantation Of Amputated Finger

Objective:To investigate the effect of Ropivacaine combined with Dexmedetomidine on myocardial injury induced by limb ischemia-reperfusion in severed finger replantation.Methods:60 patients with emergency finger replantation were randomly divided into three groups:Ropivacaine group?Ropi group?,Ropivacaine combined with Dexmedetomidine group 1?Ropi+DEX group 1?and Ropivacaine combined with Dexmedetomidine group 2?Ropi+DEX group 2?.20 patients in each group were treated with ultrasound-guided axillary brachial plexus nerve.Block.Ropi group was given 0.5%Ropivacaine 30 ml,Ropi+DEX group 1 was given 0.5%Ropivacaine and Dexmedetomidine 0.5?g/kg for 30 ml,Ropi+DEX group 2 was given 0.5%Ropivacaine and Dexmedetomidine 1.0?g/kg for 30 ml.Three groups of heart rate variability?HRV?,plasma malondialdehyde?MDA?,and plasma cardiac troponin?CTnT?in 3 groups of T₀?before anaesthesia?and T₁?6h after limb reperfusion?were recorded and NRS analgesia scores at 2h,4h,6h,12h after the end of anesthesia.Results:Compared with Ropi group,HRV in Ropi+DEX1 group was significantly lower?p<0.05?,and MDA and CTnT in plasma were significantly lower?p<0.05?.There was no significant difference in NRS analgesia score at 2h after anesthesia?p>0.05?.The NRS analgesia score was significantly lower at 4h after anesthesia?p<0.05?,and the NRS analgesia score was not significantly changed after 6h and 12h anesthesia?p>0.05?.The HRV in Ropi+DEX2 group was significantly lower?p<0.05?.MDA and CTnT were significantly decreased?p<0.05?;there was no significant difference in NRS analgesia scores at 2h after anesthesia?p>0.05?,but NRS analgesia scores were significantly lower at 4h and 6h after anesthesia?p<0.05?,anesthesia 12h The change in post-NRS analgesia score was not significant?p>0.05?.Compared with Ropi+DEX1 group,HRV was significantly lower in Ropi+DEX2 group?p<0.05?.MDA and CTnT in plasma were significantly lower?p<0.05?.There was no significant difference in NRS analgesia scores at 2h and 4h after anesthesia.?p>0.05?,but the NRS analgesia score was significantly lower after 6h anesthesia?p<0.05?.There was no significant change in analgesia score after NRS after 12h anesthesia?p>0.05?.Conclusion:The combination of Ropivacaine and Dexmedetomidine in patients with replantation of severed fingers can reduce myocardial stress injury induced by limb ischemia-reperfusion and prolong the maintenance time of anesthesia;and can reduce the perioperative stress response.And dose dependent.