关键词: 连续臂丛阻滞；断指再植；皮温；血管危象

Abstract: Objective The present study aimed to evaluate the anti-sympathetic and vasodilator effects of continuous brachial plexus block(CBPB) on the prevention of vascular crisis after finger replantation.Methods Sixty patients who underwent amputation finger replantation in our hospital from January 2023 to December 2023 were selected and divided into control group(30 cases,40 fingers,patient controlled intravenous analgesia) and study group(30 cases,44 fingers,continuous brachial plexus block analgesia) according to the postoperative analgesia.The skin temperature of the replantation finger and the hemodynamics parameters of the brachial artery of the affected limb were compared immediately,24 hours and 48 hours after replantation.The incidence of vascular crisis was compared between the two groups.Results Skin temperature of replanted fingers in the study group was (31.29±2.14)℃ and (32.16±2.34)℃ at 24h and 48h after surgery,respectively,which were significantly higher than that in the control group[(28.93±1.98)℃ and (30.03±2.52)℃,P<0.05].In terms of humeral arterial hemodynamics of the study group,the peak systolic velocity at 24 hours and 48 hours after operation was (91.45±.32.13)cm/s and（90.34±.30.86）cm/s,respectively,the data of end-diastolic velocity was （20.87±9.95）cm/s and（21.35±9.74）cm/s,respectively,the mean velocity was （38.63±12.53）cm/s and（40.53±13.30）cm/s,respectively,the blood flow was（8.95±2.57）ml/s and（8.10±2.18）ml/s,respectively,the artery area was（0.23±0.08）cm² and（0.21±0.06）cm²],respectively,the drag index was (0.73±0.23) and (0.75±0.34),respectively.While,in the control group,the ,the peak systolic velocity was (53.50±.19.24)cm/s and（52.64±.17.89）cm/s,respectively,the data of end-diastolic velocity was （13.62±3.16）cm/s and（15.38±4.33）cm/s,respectively,the mean velocity was （20.26±8.64）cm/s and（21.36±8.36）cm/s,respectively,the blood flow was （3.95±1.49）ml/s and（4.23±1.35）ml/s,respectively,the artery area was （0.18±0.05）cm² and（0.17±0.05）cm²,respectively,the drag index was (0.89±0.21) and (0.90±0.28),respectively.The difference between the two groups was statistically significant(P<0.05).The incidence of vascular crisis within 48 hours after surgery was 4.55% in the study group,which was significantly lower than 35.00% in the control group(P<0.05).Conclusion CBPB can increase blood perfusion of replanted fingers and reduce the incidence of vascular crisis.

Key words: continuous brachial plexus block；digital replantation；skin temperature；vascular crisis