ミニオープン法と鏡視下腱板修復術の術後疼痛・炎症指標の比較
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Comparisons were made to identify the transition of pain-relieving doses and their inflammatory reaction after an arthroscopic (Method-A) or a mini-open rotator cuff repair (Method-M). We reviewed the cases of mini-open-group (Method-M) including 8 males and 9 females of ages 51-71 average 62.4 and the arthroscopic-group (Method-A) including 16 males, and 22 females of ages 25-83, average 63.1. Method-M group underwent operations 10 cases/right and 7 cases/left, using 2.2 suture anchors for 178 minutes average with a follow-up of 2.8 years. Their average JOA shoulder score improved from 59.5 (pre/operation) to 94.5 when reviewed. While, method-A underwent operations 28 cases/right and 10 cases/left, using 2.1 suture anchors, for 189 minutes with a follow-up of 1.6 years. Their average JOA shoulder score improved from 59 to 94.4. We investigated the dosing frequency of postoperative pain-relief on the operation date and the postoperative 1/2/3/4/5 days. Diclofenac sodium suppository 25mg was dosed 0.7/0.7/0.3/0.1/0.1/0 times to the Group M, while 0.6/0.3/0.3/0.2/0.1/0 to the Group A. Significant difference was identified only in the first postoperative day (P=0.005) . Pentazocine intramuscular injection 15mg was dosed 0.7/0.4/0.3/0/0/0 times to the Group M, while 0.4/0.1/0.1/0/0/0 to the Group A with no significant differences except on the first (P=0.001) and second (P=0.002) postoperative days. Blood cell count transited similarly for both. The preoperative and postoperative (1st/4th/7th/14th/21st day) average CRP were respectively 0.1/3.1/4.9/1.1/0.3/0.1 mg/dl for the Group M, while 0.1/1.8/2.8/0.8/0.2/0.1 mg/dl for the Group A with no significant differences except on the first (P=0.0005) and 4th (P=0.0007) postoperative days. Method -A indicated less postoperative pain of the objectified scores, and less increase of CRP than method-M.
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