呼吸機能が低下した患者の鎖骨骨折手術に対してclavipectoral fascial plane blockが有用であった1症例

Clavipectoral Fascial Plane Block for a Patient with Respiratory Failure Undergoing Clavicular Surgery：A Case Report

要旨

　鎖骨手術に対する腕神経叢ブロック斜角筋間法は，同側の横隔神経麻痺が問題となる。近年報告されたclavipectoral fascial plane block（CPB）は，横隔神経麻痺のリスクなく，鎖骨に分布する神経終末枝を遮断する。術前に混合性換気障害を認めた患者の鎖骨骨折手術を全身麻酔とCPB併用で対応し，術後に良好な呼吸状態と鎮痛を得て管理できた。

　Although the interscalene brachial plexus block is widely used for analgesia in clavicle surgery, ipsilateral phrenic nerve paralysis remains a concern. However, the recently reported clavipectoral fascial plane block（CPB）can block the terminal nerve branches supplying the clavicle without the risk of phrenic nerve paralysis. We present a case of clavicle fracture surgery in a patient with reduced respiratory function, as indicated by preoperative pulmonary function tests. In this patient, a combination of general anesthesia and CPB maintained stable respiratory function postoperatively and provided effective pain relief.