Dexamethasone added to levobupivacaine prolongs the duration of interscalene brachial plexus block and decreases rebound pain after arthroscopic rotator cuff repair.

• 資料種別: 博士論文
• タイトル: Dexamethasone added to levobupivacaine prolongs the duration of interscalene brachial plexus block and decreases rebound pain after arthroscopic rotator cuff repair.
• 著者・編者: Morita, Shuzo; Oizumi, Naomi; Suenaga, Naoki; Yoshioka, Chika; Yamane, Shintaro; Tanaka, Yasuhito
• 著者標目: Morita, Shuzo; Oizumi, Naomi; Suenaga, Naoki; Yoshioka, Chika; Yamane, Shintaro; Tanaka, Yasuhito
• 出版事項: Elsevier
• 出版年月日等: 2020-09
• 出版年（W3CDTF）: 2020-09
• 並列タイトル等: 鏡視下腱板修復術の斜角筋間腕神経叢ブロックにおいて、レボブピバカインにデキサメサゾンを加えると鎮痛時間が延長するのみならず、術後リバウンドペインが減少する。
• タイトル（掲載誌）: Journal of shoulder and elbow surgery
• 巻号年月日等（掲載誌）: 29 9
• 掲載巻: 29
• 掲載号: 9
• 掲載ページ: 1751-1757
• ISSN（掲載誌）: ISSN : 1058-2746
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2020-12-24
• 報告番号: 甲第759号
• 学位: 博士（医学）
• 本文の言語コード: und
• 件名標目: Interscalene brachial plexus block; dexamethasone; arthroscopic rotator cuff repair; postoperative analgesia; rebound pain; shoulder surgery
• 対象利用者: 一般
• 一般注記: type:Thesis; Background: It has been reported that the addition of dexamethasone to interscalene brachial plexus block (ISBPB) prolongs the duration of the block effect. However, there have been no studies focusing on the effects of dexamethasone on rebound pain after the block effect has worn off. The aim of this study was to investigate the effect on postoperative pain when dexamethasone was added to ISBPB for arthroscopic rotator cuff repair (ARCR). Methods: In this multicenter, single-blinded, and randomized controlled study, 54 patients (33 males, 21 females) who received ARCR were randomly assigned to group L (ISBPB with 20 cc of 0.25% levobupivacaine; 21 patients) or group LD (ISBPB with 20 cc of 0.25% levobupivacaine + 3.3 mg dexamethasone; 33 patients). The primary outcome was the visual analog scale (VAS) for pain after the block effect had worn off. Secondary outcomes were the duration of analgesia, the time to the first request for additional analgesic, the number of additional doses of analgesic, and complications. Results: The VAS scores on postoperative days 0 and 1 were significantly lower in group LD than group L (P = .005, .035). This indicated that the rebound pain was relieved in group LD. After postoperative day 1, there was no significant difference in VAS score (P = .43 and .19 for days 2 and 3, respectively). The duration of analgesia was significantly longer in group LD than group L (P < .001). The time to the first request for additional analgesic was significantly longer in group LD than group L (P < .001). The number of additional doses of analgesic was significantly lower in group LD (P < .001). Conclusion: In ARCR, the addition of dexamethasone to levobupivacaine not only prolongs the duration of ISBPB but also relieves rebound pain after the block effect wears off.; 博士（医学）・甲第759号・令和2年12月24日; Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.; identifier:Journal of shoulder and elbow surgery Vol.29 No.9 p.1751-1757 (2020 Sep); identifier:10582746; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3817; identifier:Journal of shoulder and elbow surgery, 29(9): 1751-1757
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.1016/j.jse.2020.04.019
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3817/1/01%e7%94%b2759%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3817/2/02%e7%94%b2759%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3817/3/03%e7%94%b2759%e6%9c%ac%e6%96%87.pdf fulltext