半麻痺の肩の痛みにおける超音波誘導による重複的な上神経ブロックの有効性:ランダム化制御試験

Alper T Dogan¹, Yasemin Pekin Dogan², Ebru Aytekin²

¹Department of Anesthesia and Intensive Care, Amerikan Hospital, Istanbul, Turkey.

Medicine

|February 13, 2026

まとめ

重複した上神経ブロック (SSNB) は,半麻痺の肩の痛みを大幅に軽減し,脳卒中生存者の肩の運動範囲を改善します. しかし,SSNBは,この研究で,性や運動機能を改善しませんでした.

科学分野:

神経学神経学とは
リハビリテーション医学リハビリテーション医学
疼痛管理疼痛管理

背景:

半麻痺性肩こり (HSP) は,リハビリテーションに影響を与える脳卒中後の頻繁に起こる合併症です.
HSPに対する上神経ブロック (SSNB) の長期的な有効性は,特に繰り返し使用すると,さらなる調査が必要です.

研究の目的:

痛みを和らげ,運動範囲 (ROM) を向上させ,HSP患者における運動機能を改善するために,繰り返し超音波誘導SSNBの有効性を評価する.
繰り返しSSNBを投与された患者と,偽の注射を受けた患者のアウトカムを比較する.

主な方法:

42人のHSP患者を対象としたダブルブラインド,ランダム化制御試験で,SSNBまたは対照 (偽薬注射) グループに1:1の配分が行われました.
SSNBグループは,ベースライン,3週目,6週目で超音波誘導注射を受け,両グループは標準化された理学療法を受けた.
痛み (VAS),ROM (ゴニオメーター),性 (アシュワース),運動機能 (ブルンストローム) は,複数の時間点で評価されました.

主要な成果:

SSNBグループは,対照グループと比較して,介入後1,4,7週間で痛みのスコアの有意な低下を示した (P<0.05).
7週目までにSSNBグループで肩のアブドクションと屈折ROMの有意な改善が観察されました (P<0.05).
研究期間中,スパスティシティや運動機能のスコアにおいて,グループ間で有意な差異は認められませんでした.

結論:

リピートされたSSNBは,理学療法と組み合わせると,HSP患者の痛み軽減とROM改善に効果的です.
SSNBは,性や運動機能の有意な改善をもたらさなかった.
SSNBの長期的な利益を確立するために,延長されたフォローアップ期間と積極的な比較器を用いたさらなる研究が推奨されます.

キーワード:

肩の痛みが半麻痺している.運動範囲の範囲は,上神経をブロックする.超音波による超音波検査

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