Interscalene Brachial Plexus Block for Pain due to Cervical Radiculopathy and the Pain Mechanism of Referred Scapular Pain and Upper Chest Pain Yasuaki Murata 1 , Motoya Kubota 1 , Koichi Kanaya 1 , Hiroyoshi Wada 1 , Keiji Wada 1 , Masahiro Shiba 1 , Satoshi Hatta 1 , Yoshiharu Kato 1 1Department of Orthopaedic Surgery,Tokyo Woman's Medical University Keyword: 斜角筋間ブロック(interscalene brachial plexus block) , 関連痛(referred pain) , 痛みの伝達経路(pain pathway) pp.1197-1201
Published Date 2009/12/25
DOI https://doi.org/10.11477/mf.1408101638
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 Objectives:To study the pathway of scapula and upper chest pain (referred pain). Materials and Methods:Patients who had cervical radicular pain and were treated with NSAIDs for at least 2 weeks were performed the interscalene brachial plexus block (IBPB). The intensities of radicular and referred pain were measured using visual analog scale (VAS). Results:The average VAS scores for radicular pain with or without referred pain were significantly reduced by the IBPB at 5 minutes and 7 days after the injection. The referred pain was significantly reduced in the patients with stellate ganglion block (SGB) effect than those without SGB effect. Conclusions:The referred pain pathway was likely interrupted by IBPB with the side effect of SGB. The main afferent fibers of the cervical related pain pathway were thought to involve the T1 and/or T2 spinal nerve,presumably via sympathetic afferents.

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