鏡視下腱板修復術における持続腕神経叢ブロックは術後可動域回復に影響するか

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Background: The pain after ARCR is severe especially for two days after surgery. The continuous interscalene block (CIB) can prevent this pain effectively. Although we guess that CIB is useful for postoperative rehabilitation, it has not been previously reported. We reviewed whether CIB influenced postoperative ROM restoration. Methods: We evaluated 12 shoulders (7 male, 5 female) which had ARCR with CIB performed (group C) and 18 shoulders (11 male, 7 female) with the temporary interscalene block (group T). The range of the age of group C was 57-75 years (average : 63.0 years old) and group T was 49-74 years (average : 67.2 years old) . We evaluated the transition of ROM ; passive anterior elevation (AE), passive external rotation in 90 degrees of abduction (ER2) and passive internal rotation in 90 degrees of abduction (IR2) at 2 weeks, 3 and 6 months postoperatively, in addition, active anterior elevation (aAE), active abduction (aAB), passive external rotation (ER1) and active external rotation (aER1) at 3 and 6 months postoperatively. Results: For the evaluated ROM no significant difference were seen between the two groups. Discussion: The various factors affect the restoration of postoperative ROM, such as preoperative contracture and the skill of therapist etc. Analgesia by CIB may act to reduce anxiety and muscle spasm. Reconsideration of the evaluation about the effect of CIB is nessesary.
日本肩関節学会の論文