新しい肩甲上神経ブロックの開発 ―屍体肩を用いた検討―

概要

論文の詳細を見る
Suprascapular nerve block is 1 of the methods to relieve shoulder pain, however, it is not completely effective. The objectives of this study were to develop a new block procedure. 8 cadaver shoulders were dissected and we investigated the anatomical lesion of sensory branches of suprascapular nerve. 3 needles were inserted with the 3 methods as follows; 1) method reported by Moore, 2) method reported by Wassef and 3) our original method. The distance from the needle tip to the sensory branch was measured. 8 patients who had severe postoperative pain after a rotator cuff repair operation received a suprascuplar nerve block by our original method. Their visual analog scale(VAS) and face scale were recorded before receiving a block to 24-hour after the block.All cadaver shoulders had 2 or 3 sensory branches after just passing the scapular notch. The average distance from the needle tip to the sensory branch was 16.1mm in Moores method, 9.1mm in Wassefs methods and 4.6mm in our original method, respectively.Before receiving a nerve block, their average VAS was 5.4±2.7. After the block, the VAS had improved from 5.4 to 1.2 and 4-h was 0.8±0.8. We expect our original suprascapular nerve block will be 1 of the postoperative managements for pain relief after rotator cuff surgery.