術前の斜角筋間ブロックによる術中血圧・疼痛のコントロール効果

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We were often distressed by bleeding through arthroscopic rotator cuff repair (ARCR). It is important to control blood pressure (BP) for the prevention of bleeding. Since June 2007, we performed shoulder surgery under general anesthesia and interscalene brachial plexus block by ultrasound (US) imaging guide for decreasing postsurgical pain. The purpose of this study was to evaluate the efficacy for pain and BP control by interscalene block for ARCR. 48 patients who underwent ARCR by interscalene block were involved. They were divided into 3 groups. Non-block group (group N) consisted of 23 cases, 14 men and 9 women, whose average age was 60.4 years old. Non-block group using prostaglandin E1 (group P) consisted of 13 cases, 8 men and 5 women, 63.1 years old. Block group (group B) consisted of 7 cases, 5 men and 7 women, 65.1 years old. We compared the decreasing rate of BP ({preoperative BP - average BP during surgery} / preoperative BP ) and fluctuations of BP during surgery among the 3 groups. The backgrounds of patients did not recognize a significant difference between the 3 groups. Decreasing rate of BP of group B was higher than the other groups significantly. The fluctuations of BP (standard deviation of BP during surgery every 5 minutes) was 12.83/7.60mmHg in group N, 14.87/8.12mmHg in group P, 6.69/3.99mmHg in group B. The fluctuations of BP of group B was lower than other groups significantly. In group B, patients did not need analgesics during and just after surgery. The interscalene block before induction under US imaging guide was a safe method for ARCR. The interscalene block provides good pain relief following surgery and easy BP control during surgery.
日本肩関節学会の論文
2009-07-27

術前の斜角筋間ブロックによる術中血圧・疼痛のコントロール効果

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