脛骨神経のフエノールブロック : M波, H波, 支配筋の選択的ブロック, ブロックによる疼痛

概要

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When blocking the tibial nerve of hemiplegics, monitoring of M. & H. wave from M. Triceps suae is very useful to help block it exactly and with less dosage of phenol.It also makes it possible to selectively block α-efferent or γ-efferent fiber.From the view-point of strength-duration curve of M. & H. wave and H/M ratio, physiologically better results were obtained when phenol solution was injected where H & H-M wave were noted eliminating the points where only M wave was noted, suggesting the injected phenol solution reacts locally and doesn't infiltrate around there.Three groups of the innervated muscles (1,Triceps surae, 2,Tibialis posterior, 3,Flexor hallucis longus & brevis, Flexor digitorm longus & brevis) can be also selectively blocked, which makes it possible for example, to relieve the pains caused by hammer toes with the less muscle power decrement of Triceps surae.The recurrence of spasticity depends not only on the previous spasticity itself but also on the potential of the antagonists. The muscle power potential of the ankle dorsiflexors makes it easier and longer to continue the reduced tonus of Triceps surae.Neuritic pains of the innervated muscles have been noted in 20% of the blocked patients, but they are reduced to 10.6% by using physiologically isotonic solution. (2% phenol & 0.25% NaCl)
社団法人日本リハビリテーション医学会の論文
1974-01-18