Continuous Interscalene Brachial Plexus Block for Shoulder Mobilization and Rehabilitation

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  • SAKAMOTO Seishi
    Department of Anesthesia, Japan Community Healthcare Organization Tokuyama Central Hospital
  • NAKANISHI Toshiyuki
    Department of Anesthesia, Japan Community Healthcare Organization Tokuyama Central Hospital
  • YOSHIMURA Manabu
    Department of Anesthesia, Japan Community Healthcare Organization Tokuyama Central Hospital
  • TORIUMI Takashi
    Department of Anesthesia, Japan Community Healthcare Organization Tokuyama Central Hospital
  • NAGAHIRO Yukio
    Department of Orthopedics, Japan Community Healthcare Organization Tokuyama Central Hospital
  • SUMIURA Seiji
    Department of Orthopedics, Japan Community Healthcare Organization Tokuyama Central Hospital

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Other Title
  • 肩関節授動術と術後リハビリテーションに超音波ガイド下持続腕神経叢ブロックが有効であった一例
  • カタカンセツ ジュドウジュツ ト ジュツゴ リハビリテーション ニ チョウオンパ ガイドカ ジゾク ワンシンケイソウ ブロック ガ ユウコウ デアッタ イチレイ
  • 症例報告 肩関節授動術と術後リハビリテーションに超音波ガイド下持続腕神経叢ブロックが有効であった一例
  • ショウレイ ホウコク カタカンセツジュドウジュツ ト ジュツゴ リハビリテーション ニ チョウオンパ ガイド カ ジゾク ワン シンケイソウブロック ガ ユウコウ デ アッタ イチレイ

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Abstract

<p>A 67-year-old man, with prior open reduction and internal fixation surgery for a proximal humeral fracture 3 months before, was admitted for wire extraction and shoulder mobilization to relieve joint stiffness.</p><p>General anesthesia and continuous interscalene brachial plexus block（CISB）were scheduled. A Contiplex® C needle（B.Braun）was inserted between C5 and C6 under ultrasound guidance before induction of general anesthesia. After 15 mL 0.25% levobupivacaine was injected, the needle was withdrawn while holding the catheter. No significant change in vital signs was observed intraoperatively. Continuous infusion of 0.2% ropivacaine at 6mL/h was started immediately postoperatively.</p><p>The patient presented motor block only on the day of the surgery. The reported Visual Analogue Scale scores for pain at rest and on rehabilitation were 0?20 and 26?65 mm, respectively. During the infusion of CISB, supplemental analgesia was only 1 tablet of loxoprofen. The catheter was removed on postoperative day（POD）3 and the patient discharged on POD13 with good range of motion in the shoulder joint. Pain after shoulder surgery hinders effective physiotherapy；however, this patient was able to undergo rehabilitation with decreasing pain because of CISB use.</p>

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