腱板断裂修復術における頸部持続硬膜外麻酔の有用性

抄録

Purpose Early rehabilitation for rotator cuff repair is necessary to prevent joint contracture, muscle atrophy or reflex sympathetic dystrophy. Recently, we carried out early rehabilitation under cervical continuous epidural anesthesia (CCEA). The purpose of this study is to evaluate the value of CCEA on rotator cuff repair.
Materials and Methods
39 patients were operated on without CCEA (group non-CCEA). They consisted of 25 males and 14 females whose average age was 60.6 years. At the operation, we found complete tears of the rotator cuff in 32 cases and incomplete tears in 7 cases.19 patients were operated on under CCEA (group CCEA). They consisted of 14 males and 5 females whose average age was 61.8 years. At the operation, we found complete tears of rotator cuff in 14 cases and incomplete tears in 5 cases. These two groups were examined and evaluated by the Japanese Orthopaedic Association (JOA)score before surgery,3 months after surgery and 6 months after surgery.
Results
Before surgery, the average JOA score was 58.1 for group non-CCEA and 56.5 for group CCEA. At 3 months after surgery, the average JOA score was 76.5 for group non-CCEA and 83.6 for group CCEA. At 6 months after surgery, the average JOA score was 89.7 for group non-CCEA and 92.1 for group CCEA.
Conclusion
CCEA facilitates an early rehabilitation for rotator cuff repair. As a result, the rehabilitation period gets shorter and good results are obtained earlier.