Evidence map›Paper›PMID 31918668›Full record

Trial reportBMC anesthesiology2020

A prospective, randomized comparison of ultrasonographic visualization of proximal intercostal block vs paravertebral block.

Kamen Vlassakov, Avery Vafai, David Ende, Megan E Patton, Sonia Kapoor, Atif Chowdhury, Alvaro Macias, Jose Zeballos, David R Janfaza, Sujatha Pentakota and 1 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02911168 (A Prospective, Randomized Comparison Between the Ultrasound Guided Paravertebral Block and the Ultrasound Guided Proximal Intercostal Nerve Block), which is not on this map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02911168 nacompletednot on this map

A Prospective, Randomized Comparison Between the Ultrasound Guided Paravertebral Block and the Ultrasound Guided Proximal Intercostal Nerve Block

TypeinterventionalSponsorBrigham and Women's HospitalRan2016 to 2020Enrolled20ConditionsPainArmsProximal Intercostal Block, Paravertebral Block
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Kamen VlassakovDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
Avery VafaiDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
David EndeDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
Megan E PattonDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
Sonia KapoorDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
Atif ChowdhuryDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
Alvaro MaciasDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
Jose ZeballosDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
David R JanfazaDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
Sujatha PentakotaDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA.
Kristin L SchreiberDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 75 Francis St, Boston, MA, 02115, USA. klschreiber@bwh.harvard.edu.
Brigham and Women's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThoracic paravertebral blockade is an accepted anesthetic and analgesic technique for breast surgery. However, real-time ultrasound visualization of landmarks in the paravertebral space remains challenging. We aimed to compare ultrasound-image quality, performance times, and clinical outcomes between the traditional parasagittal ultrasound-guided paravertebral block and a modified approach, the ultrasound-guided proximal intercostal block.

methodsWomen with breast cancer undergoing mastectomy (n = 20) were randomized to receive either paravertebral (n = 26) or proximal intercostal blocks (n = 32) under ultrasound-guidance with 2.5 mg/kg ropivacaine prior to surgery. Block ultrasound images before and after needle placement, and anesthetic injection videoclips were saved, and these images and vidoes independently rated by separate novice and expert reviewers for quality of visualization of bony elements, pleura, relevant ligament/membrane, needle, and injectate spread. Block performance times, postoperative pain scores, and opioid consumption were also recorded.

resultsComposite visualization scores were superior for proximal intercostal compared to paravertebral nerve block, as rated by both expert (p = 0.008) and novice (p = 0.01) reviewers. Notably, both expert and novice rated pleural visualization superior for proximal intercostal nerve block, and expert additionally rated bony landmark and injectate spread visualization as superior for proximal intercostal block. Block performance times, needle depth, opioid consumption and postoperative pain scores were similar between groups.

conclusionsProximal intercostal block yielded superior visualization of key anatomical landmarks, possibly offering technical advantages over traditional paravertebral nerve block.

trial registrationClinicalTrials.gov, NCT02911168. Registred on the 22nd of September 2016.

Indexed as

AdultAgedAnalgesics, OpioidAnesthetics, LocalBreast NeoplasmsFemaleHumansIntercostal NervesMastectomyMiddle AgedNeedlesNerve BlockPleuraPostoperative PainProspective StudiesRopivacaineAnalgesics, OpioidAnesthetics, LocalRopivacaineAcute painMastectomyParavertebralPostoperative painProximal intercostalTruncal blockUltrasound

Identifiers

PMID31918668
PMCPMC6953256
OpenAlexW3004172312

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.