クライオセラピーは直視下・鏡視下腱板修復術後の疼痛軽減に有用か?

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Cryotherapy is widely used after surgery expecting to reduce pain, swelling, and inflammation. However, there have been only few studies about cryotherapy after shoulder surgery. We designed a prospective randomized study to evaluate the effects of cryotherapy on postoperative pain control after open and arthroscopic rotator cuff repair (ORCR, ARCR). There were 5 shoulders (1 large and 4 massive tears) in the control group of ORCR, 6 shoulders (1 large and 5 massive tears) in cryothrapy group of ORCR, 6 shoulders (1 small, 2 medium, and 3 large tears) in the control group of ARCR, and 6 shoulders (5 medium and 1 large tear) in cryotherapy group of ARCR. Drainage tubes with a temperature sensor were placed inside the glenohumeral joint (GHJ) and subacromial bursa (SAB). In the cryotherapy group, the shoulder was continuously cooled using the Icing System CF3000 (Nippon Sigmax, Co.) 48 hours after operation at 5°C; no cooling was applied in the control group. Temperatures, VAS, and the uses of pain-relief drugs (diclophenac Na suppository and pentazocin injection) during 48 hours after surgery were evaluated. In ORCR, the cryotherapy group showed significantly lower temperature of SAB. In ARCR, the cryotherapy group also showed a lower temperature of SAB, however, the difference was greater in ORCR. There was no difference of GHJ temperature in both ORCR and ARCR. The percentage of cases with maximum VAS 8-10 (control / cryotherapy) was 50% / 17% in ORCR and 50% / 33% in ARCR. Pentazocin injection was used more in the control group of ORCR than other groups. The cooling effect on SAB was larger in ORCR than ARCR probably because thicker wound dressing gauze containing irrigation fluid prevents the cooling effect in ARCR. In conclusion, cryotherapy is effective for postoperative pain control after both ORCR and ARCR, however, a more effective method of cooling should be considered for ARCR.
2009-07-27

クライオセラピーは直視下・鏡視下腱板修復術後の疼痛軽減に有用か?

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