斜角筋間腕神経叢ブロックによる肩関節鏡手術

抄録

We always perform shoulder arthroscopic surgery with general anesthsia. But there were some cases where we could not use general anesthesia due to their complications etc. We investigated the clinical results of interscalene brachial plexus block for shoulder arthroscopic surgery. The interscalene brachial plexus block was performed on 9 shoulders from 2008 to 2010. There were 6 males and 3 females with an average age of 52.2 years old. There were 4 right and 5 left sides. Arthroscopic repair for rotator cuff tear was performed on 1 shoulder. Arthroscopic debridement for massive tears of rotator cuff tears were performed on 3 shoulders. Arthroscopic treatment for labrums were performed on 2 shoulders. Arthroscopic subacromial decompression for subacromial impingement syndromes were performed on 2 shoulders. Arthroscopic excision of distal clavicle for acromioclavicular joint dislocation was performed on 1 shoulder. The block was performed using a standard technique with the patient supine. The interscalenic groove was identified with the patient's head turned to the side opposite to that being blocked. Skin puncture was performed at about 3cm above the middle of the clavicle, and anesthetic was injected. The operation times were 53-105 minutes (average 76.7 minutes). Mepivacaine hydrochloride (1.5%) was used with an average of 23.6ml and ropivacaine hydrochloride hydrate (0.75%) was used with an average of 20.0ml. Additionally, pentazocine was used in one case. Enough analgesia was got during the operations. No complications were observed. The clinical results of interscalene brachial plexus block for shoulder arthroscopic surgery were good.