鏡視下腱板修復術におけるエコーガイド下腕神経叢ブロックの術後疼痛抑制効果の検討

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Background: As arthroscopic shoulder surgery is often associated with severe postoperative pain, it is reported to be important to manage it. We evaluated the effect of the plexus brachialis block to reduce post operative pain after arthroscopic rotator cuff repair. Methods: Thirty-five patients with arthroscopic rotator cuff repair were divided into 2 groups; 1) Block group (with plexus brachialis block) which included 9 men and 6 women, with a mean age of 66.5 years old, 2) Control group (without plexus brachialis block) which included 14 men and 6 women, with a mean age of 64.0 years old. Under general anesthesia, the plexus brachialis blocking was performed using the ultrasonographic guide. Post operative pain was assessed using visual analog scale (VAS) and the usage of the NSAIDs at 4, 8, 16 and 24 hours after surgery. Results: The VAS at 4 and 8 hours postoperatively were significantly lower in the Block group than the Control group. The VAS at 16 and 24 hours were also lower in the Block group when compared with the Control group. The total amount of the painkillers used during the first postoperative 24 hours was greater in the Control group compared with the Block group. As for complications, fugitive motor paralysis, which recovered within several hours, was found in some patients, but no severe complications such as nerve injury or pneumothorax were seen. Conclusion: The plexus brachialis blockade is effective to reduce post operative pain after arthroscopic rotator cuff repair.

鏡視下腱板修復術におけるエコーガイド下腕神経叢ブロックの術後疼痛抑制効果の検討

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