Alternative Title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。
Periodical titleJournal of shoulder and elbow surgery
Note (General)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
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2021-05-23T18:24:43+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション