乳がんの骨転移による大腿骨骨幹部骨折に対する骨折観血的手術を大腿神経・外側大腿皮神経ブロック下で行った1症例

A Case of Femoral Diaphyseal Fracture due to Bone Metastasis of Breast Cancer Treated with Surgery Using Femoral Nerve Block and Lateral Femoral Cutaneous Nerve Block

要旨

　今回，乳がんの多発転移による全身状態不良の大腿骨骨幹部骨折患者に対する，大腿骨遠位部からの逆行性髄内釘挿入術を，大腿神経・外側大腿皮神経ブロック下に行うことができた1症例を経験した。全身麻酔，脊髄くも膜下麻酔が困難な患者に対する大腿骨遠位部からの逆行性髄内釘挿入術に対して，末梢神経ブロックは有効である可能性がある。

　We report a case of successful anesthesia using femoral nerve block plus lateral femoral cutaneous nerve block, for retrograde intramedullary nail insertion from the knee in a patient with femoral diaphyseal fracture who was in poor general condition due to multiple metastases of breast cancer.

　Recently, ultrasound-guided peripheral nerve blocks are added to general anesthesia, to provide better analgesia and to reduce opioid use, which may improve prognosis. Peripheral nerve blocks may also be indicated in patients in whom general or spinal anesthesia is not indicated.

　We believe that in a patient whose general condition is poor and general anesthesia is not suitable, ultrasound-guided peripheral nerve block and sedation may be a suitable anesthesia method in patient undergoing orthopedic surgery of the lower legs.