ObjectiveTo observe the effect of postoperative analgesia with continuous brachial plexus block on vascular crisis after digital replantation. MethodsSixty-six patients with digital replantation were randomly divided into study group and control group, with 33 cases in each group. Both groups underwent digital replantation.After operation, the study group received continuous brachial plexus block (20 mL of 1% ropivacaine, 100 μg of sufentanil, 10 mg of dezocine, 25 mg of dolasetron and 100 mL of normal saline) for analgesia, and the control group received the intravenous analgesia (150 μg of fentanyl, 15mg of dezocine, 25mg of dolasetron and 100mL of normal saline). The postoperative pain severity (VAS score), blood supply, difference in skin temperature between uninjured side and affected side, the incident rate of postoperative vascular crisis and the survival rate of digital replantation were compared between the two groups. ResultsAt 4 h, 8 h, 12 h, 24 h and 48 h after operation, the VAS scores and the difference in skin temperature between uninjured side and affected side in the study group were significantly lower than those in the control group (all P＜0.05). The postoperative capillary filling time and the SpO2 level was higher in the study group compared to the control group（all P＜0.05）.The incidence rate of postoperative vascular crisis in the study group was lower than that in the control group (3.03% vs 24.24% ,P＜0.05) . The survival rate of digital replantation in the study group was higher than that in the control group (100% vs 84.85%, P＜0.05). ConclusionFor digital replantation, analgesia with continuous brachial plexus block can achieve a superior efficacy to intravenous analgesia, and is benefit to the blood circulation, can lower the incident rate of postoperative vascular crisis and elevate the survival rate of replantation.

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