鏡視下腱板修復術後の疼痛コントロール法の比較
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The aim was to assess alternative methods of post operative pain control with the continuous morphine injection and the continuous interscalene block in patients undergoing rotator cuff repair surgery. Forty-four patients were included in this study. Morphine (M) group consisted of 18 cases. Interscalene block (ISB) group consisted of 26 cases. All patients had interscalene block with 0.75%-ropivacane and 2% lidocane by single surgeon following induction of general anesthesia. In M group, glenohumeral joint injection with 20ml of 2% lidocane with epinephrine was administrated at the end of surgery and followed by postoperative injection of morphine (0.4-0.5mg/hr) and doroperidol (0.05-0.125mg/hr in cases of less than 70 years old). In group ISB, continuous interscalene block with 0.2%-ropivacane was administered. Data collected were the difference between systolic pressure, pain at recovery from anesthesia, the number of times that sharp pain appeared, number of pain medications, number of nighttime awakenings, and incidence of adverse effects. A total of 42 patients (95%) had a successful block. In M group, three patients had sharp pain at recovery from anesthesia. The number of times that sharp pain appeared was 3.0 ± 2.6 in M group and 1.3 ± 1.1in ISB group, the number of nighttime awakenings was2.4 ± 1.5, 1.8 ± 1.4 times, the number of patients vomiting was 5 (28%) and 2 (7.7%), respectively. No complications, including pneumothorax and nerve injury, were observed. Interscalene plexus block before surgery and continuous interscalene plexus block in the postoperative period has few side effects, and sharp pain control is possible.
- 2010-08-04
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