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Rinsho Seikei Geka Volume 49, Issue 5 （May 2014）

臨床整形外科 49巻5号（2014年5月発行）

Japanese English

論述

周術期総腓骨神経麻痺―下肢手術での予防と対策 New Measures to Prevent Perioperative Common Peroneal Nerve Palsy in Lower Extremity Surgery Patient 玉置康之 ¹ , 百名克文 ¹ , 田中康之 ¹ , 井上悟史 ¹ , 川井康嗣 ¹ , 打越顕 ¹ , 丸山征爾 ¹ , 馬谷直樹 ¹ , 坂口雅彦 ¹ , 中村賢司 ¹ , 古川剛 ¹ , 岩井輝修 ¹ , 光澤定己 ¹ , 仲谷健次 ¹ Yasuyuki TAMAKI ¹ , Katsufumi HYAKUNA ¹ , Yasuyuki TANAKA ¹ , Satoshi INOUE ¹ , Yasutsugu KAWAI ¹ , Akira UCHIKOSHI ¹ , Seiji MARUYAMA ¹ , Naoki UMATANI ¹ , Masahiko SAKAGUCHI ¹ , Kenji NAKAMURA ¹ , Takeshi FURUKAWA ¹ , Terunobu IWAI ¹ , Sadaki MITSUZAWA ¹ , Kenji NAKATANI ¹ ¹日本赤十字社和歌山医療センター整形外科 ¹Department of Orthopaedic Surgery, Japanease Red Cross Society Wakayama Medical Center キーワード：総腓骨神経麻痺 , common peroneal nerve palsy , 周術期 , perioperative , 予防 , prevention Keyword: 総腓骨神経麻痺 , common peroneal nerve palsy , 周術期 , perioperative , 予防 , prevention pp.411-414

発行日 2014年5月25日 Published Date 2014/5/25

DOI https://doi.org/10.11477/mf.1408103037

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　目的：周術期総腓骨神経麻痺予防の新たな対策の効果を検討した．

　対象と方法：対策として，パンフレット作成，総腓骨神経のマーキング，チェックリスト作成，下肢枕の工夫を行った．対象は全身麻酔または腰椎麻酔の下肢手術症例で，対策前の987例をBefore群，対策後の1,196例をAfter群とし，総腓骨神経麻痺発生率を検討した．

　結果：麻痺発生率は，Before群0.4％(4例)，After群0％(0例)で，有意差を認めた．

　まとめ：周術期総腓骨神経麻痺は，医療者側の観察の具体化，患者側への働きかけ，下肢枕の工夫を行うことで予防が可能である．

　Purpose：We assessed the effectiveness of new measures to prevent perioperative common peroneal nerve palsy.

　Materials and methods：Preparation of a pamphlet, marking, making a checklist, and a leg pillow device were used as new measures.　To prevent perioperative common peroneal nerve palsy in patients who undergo lower limb surgery under general anesthesia or spinal anesthesia.　The incidence of common peroneal nerve palsy in two groups of patients was compared：a group of 987 patients who underwent surgery before the new measures were introduced, i.e., the before group, and a group of 1,196 patients who underwent surgery after the new measures were introduced, i.e., the after group.

　Results：The incidence of palsy was 0.4% in the before group (4 patients) and 0% in the after group (0 patients), and the difference between the two groups was significant.

　Conclusions：Prevention of perioperative common peroneal nerve palsy was made possible by definite observation by the surgical team, approaching to the patient side and the leg pillow device.