Effect of dexmedetomidine combined with ropivacaine block on flap blood flow and patient satisfaction after flap transfer for hand trauma: a randomized controlled trial.

The purpose of this study was to assess the effect of dexmedetomidine as a local anaesthetic adjuvant on flap blood flow and patient satisfaction regarding postoperative analgesia anterolateral thigh free flap transfer for hand trauma. A total of 66 patients were randomized into two groups. One group was treated with intermittent 1.0 µg/mL dexmedetomidine + 0.125% ropivacaine bolus at 8 mL/2 h and the other with intermittent 0.2% ropivacaine bolus at 8 mL/2 h, administered via continuous infraclavicular brachial plexus block. Dexmedetomidine had no significant effect on the flap blood supply and had a good safety profile. Moreover, 1.0 µg/mL dexmedetomidine + 0.125% ropivacaine provided similar satisfactory postoperative analgesia as 0.2% ropivacaine (p > 0.05), reduced hand numbness and motor block, and improved patient satisfaction (p < 0.05). All the flaps in the dexmedetomidine + ropivacaine group and 30 of 31 flaps in the ropivacaine group survived. The addition of dexmedetomidine to the local anaesthetic infusion appears to be a safe method of improving postoperative symptoms.Level of evidence:I.