図 4
術後痛の評価部位
持続硬麻
単独側
＊
＊＊＊
＊＊
＊＊＊ (VAS mm)
0 10 20 30 40 50 60 70 80 90 100
E C+E E C+E E C+E E C+E E C+E E C+E
2h 4h 8h 12h 24h 48h
＊ ＊
Group E : 持続硬麻単独側 Group C+E: CFNB併用側
安 静 時 VAS
図 5
最大値最小値
中央値 25-75%値
（時間）
＊
＊＊ ＊＊＊ ＊＊＊
＊＊＊ (VAS mm)
0 10 20 30 40 50 60 70 80 90 100
E C+E E C+E E C+E E C+E E C+E E C+E
2h 4h 8h 12h 24h 48h
＊
Group E : 持続硬麻単独側 Group C+E: CFNB併用側
図 6
最大値最小値
中央値 25-75%値
（時間）
体 動 時 VAS
＜図 説＞
図
1 CFNB
カテーテル挿入手順（右側鼠径部）①鼠径靭帯より
2cm
末梢側と大腿動脈より1cm
外側の交点を刺入点とし マーキング。②電気を絶縁できる
5cm
の持続末梢神経ブロック用Tuohy
穿刺針(Contiplex
®A Set: B. Braun
社Germany)
による穿刺。③神経刺激装置
(Stimuplex
®-DIG :B. Braun
社Germany)の電気刺激 (0.5mAmp. 0.1ms. 1Hz)
による大腿四頭筋の痙縮（膝蓋骨の動き）によ り大腿神経を同定。④
CFNB
カテーテルを皮下約15
㎝挿入し、2-0
絹糸にて穿刺部位の皮膚 に1
糸縫合し固定。CFNB: continuous femoral nerve block
（持続大腿神経ブロック）図
2 CFNB
穿刺部位とカテーテル(
左側鼠径部)
鼠径靭帯より
2cm
末梢側と大腿動脈より1cm
外側の交点を刺入点とし、CFNB
カテーテルを中枢側へ皮下約15
㎝挿入し、2-0
絹糸にて穿刺部位 の皮膚に1
糸縫合し固定。CFNB: continuous femoral nerve block
（持続大腿神経ブロック）図
3 CFNB
ブロック針と末梢神経刺激装置のセッティング電 気 を 絶 縁 で き る
5cm
の 持 続 末 梢 神 経 ブ ロ ッ ク 用Tuohy
穿 刺 針(Contiplex
®A Set: B. Braun
社Germany)
による穿刺と神経刺激装置(Stimuplex
®-DIG :B. Braun
社Germany)
の電気刺激(0.5mAmp. 0.1ms.
1Hz)
による大腿四頭筋の痙縮（膝蓋骨の動き）により大腿神経を同定。CFNB: continuous femoral nerve block（持続大腿神経ブロック）
図
4
術後痛の評価部位同一患者の左右下肢を、
CFNB
カテーテルを挿入していない下肢を持続 硬麻単独側(E
群)
、CFNB
カテーテルを挿入した下肢をCFNB
併用側(C+E
群)
とし、左右下肢別に痛みの大きさを評価。CFNB: continuous femoral nerve block
（持続大腿神経ブロック）図
5
術後安静時におけるVisual analog pain scale scores (VAS)
値 箱グラフは、中央値、25-75%
値を示し、ひげは最大値と最小値を示す。各評価時点で
Wilcoxon
順位和検定にて群間比較を実施した。CFNB
併用側は、持続硬麻単独側に比し全ての評価時点で有意なVAS
値 の減少を認めた。CFNB: continuous femoral nerve block*P < 0.05, **P < 0.01, ***P < 0.001 (vs. Group E: 持続硬麻単独側)
図
6
術後体動時におけるVisual analog pain scale scores (VAS)
値 箱グラフは、中央値、25-75%
値を示し、ひげは最大値と最小値を示す。各評価時点で
Wilcoxon
順位和検定にて群間比較を実施した。CFNB
併用側は、持続硬麻単独側に比し全ての評価時点で有意なVAS
値 の減少を認めた。CFNB: continuous femoral nerve block*P < 0.05, **P < 0.01, ***P < 0.001 (vs. Group E: 持続硬麻単独側)
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