パンコースト腫瘍に伴う肩甲骨内側の痛みに脊柱起立筋膜面ブロックを施行した1症例

Erector Spinae Plane Block Provided Good Pain Relief for the Periscapular Pain by Pancoast Tumor：A Case Report

要旨

　パンコースト腫瘍に伴うコントロール不良の疼痛に対して脊柱起立筋膜面ブロックを行った。単回注入では薬液が脊柱側面に沿って広がり効果が得られたが，持続投与では不十分であった。局所麻酔薬の注入方法の工夫が必要であると考えられた。

　A patient with poorly controlled pain associated with a Pancoast tumor under anticoagulation was treated with an erector spinae plane block. A single injection of 20 ml 0.25％ ropivacaine spread along the spinal column and provided good pain relief. However, insertion of a catheter with continuous infusion of 0.1％ ropivacaine at 5 ml・hr⁻¹ was not effective enough for the next day. We speculate that to increase the efficacy of continuous block, it is necessary to employ an infusion method such as increasing the continuous dose flow rate or intermittent bolus administration.