肩手術に対する斜角筋間腕神経叢ブロックの使用経験

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We always perform shoulder surgery with general anesthsia. But there were some cases that we could not use general anesthesia for their complications etc. We investigated the clinical results of interscalene brachial plexus block for shoulder surgery. The interscalene brachial plexus block was performed on 8 shoulders from 2007 to 2008. There were 4 males and 4 females with an average age of 52.5 years old. There were 5 right sides and 3 left. Arthroscopic subacromial decompression for subacromial impingement syndromes were performed on 2 shoulders. Arthroscopic debridement for massive tears of rotator cuff tears were performed on 2 shoulders. Bosworths operation for acromioclavicular joint dislocation was performed on 1 shoulder. Operations for distal clavicle fractures were performed on 3 shoulders. The block was performed using a standard technique with the patient supine. The interscalenic groove was identified with the patients head turned to the side opposite to that being blocked. Skin puncture was performed at about 3cm upper part of the middle of the clavicle, and Mepivacaine hydrochloride (1.5%) was injected. The operation times were 22-101 minutes (average 55.0 minutes). Mepivacaine hydrochloride (1.5%) was used with 20-30ml (average 26.3ml). Small volumes of local anesthesia (lidocaine hydrochloride) were used in 3 cases additionally at the skin incision. Additional anesthesia during the operations was not required in all cases. No complications were observed. The clinical results of interscalene brachial plexus block for shoulder surgery were good.
日本肩関節学会の論文
2009-07-27

肩手術に対する斜角筋間腕神経叢ブロックの使用経験

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