RESUMO
Objective To explore the clinical effect of propacetamol and dezocine for the prevention and treatment of vascular crisis in the preemptive analgesia after digit replantation.Methods 85 cases of patients treated with digit replantation were selected for the study and divided into the propacetamol group (n =45) and the dezocine group (n =40) according to the different postoperative preemptive analgesic method.The two groups were given with propacetamol or dezocine and fentanyl and ondansetron patient-controlled intravenous analgesia (PCIA) respectively.The analgesic and sedative effects were observed between the two groups,and the occurrence of vascular embolism and vascular crisis and the survival rate of rcplantation were counted.Results There was no significant difference between the two groups in the visual analogue pain score (VAS) at 3 hours after operation (P ＜0.05).The VAS scores of the two groups were significantly increased at 6 h and 24 h after operation while the VAS score was significantly decreased at 48 h after operation (P ＜ 0.05),and the VAS scores were significantly lower in the propacetamol group than those in the dezocine group at 6 h,24h and 48 h after operation (P ＜ 0.05).The difference of the Ramsay sedation scores distribution at 3 hours after operation was statistically significant between the two groups (P ＜ 0.05),and the sedative effect was more satisfactory in the propacetamol group.Within 48 h after operation,PCI effective times/actual sub values of the propacetamol group were significantly higher than the dezocine group (P ＜0.05).The incidence rates of postoperative vascular thrombosis and arterial or venous crisis were 4.44％,6.67％ and 6.67％ respectively in the propacetamol group,which were significantly lower than those in the dezocine group with 20.00％,22.50％ and 27.50％ (P ＜ 0.05).The survival rate of digit replantation,digit replantation at 6 months after treatment were 97.78％,85.00％ which was higher than that of the dezocine group with 91.11％,75.00％ (P ＜ 0.05).Conclusions Compared with dezocine,propacetamol can attain the ideal analgesic and sedative effects and improve the survival rate of replantation,which has a significant role in the prevention and treatment of vascular crisis in the adjuvant treatment of postoperative analgesia in digit replantation.