Evidence map›Paper›PMID 35012992›Full record

Trial reportRegional anesthesia and pain medicine2022

Depth of cervical plexus block and phrenic nerve blockade: a randomized trial.

Mathias Opperer, Reinhard Kaufmann, Matthias Meissnitzer, Florian K Enzmann, Christian Dinges, Wolfgang Hitzl, Jürgen Nawratil, Andreas Koköfer

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Regional anesthesia and pain medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
5.5field-weighted citation impact, top 3% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 39 citations in OpenAlex.

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  18. Perioperative Diaphragm Dysfunction.Journal of clinical medicine · 2024
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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

8 authors at 1 institution in 1 country.

Mathias OppererDepartment of Anesthesiology, Paracelsus Medical University, Salzburg, Austria m.opperer@salk.at.
Reinhard KaufmannDepartment of Radiology, Paracelsus Medical University, Salzburg, Austria.
Matthias MeissnitzerDepartment of Radiology, Paracelsus Medical University, Salzburg, Austria.
Florian K EnzmannDepartment of Cardiac, Vascular and Endovascular Surgery, Paracelsus Medical University, Salzburg, Austria.ORCID 0000-0002-7200-4145
Christian DingesDepartment of Cardiac, Vascular and Endovascular Surgery, Paracelsus Medical University, Salzburg, Austria.
Wolfgang HitzlDepartment of Ophthalmology and Optometry, Paracelsus Medical University, Salzburg, Austria.
Jürgen NawratilDepartment of Anesthesiology, Paracelsus Medical University, Salzburg, Austria.
Andreas KoköferDepartment of Anesthesiology, Paracelsus Medical University, Salzburg, Austria.
Paracelsus Medical University · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesCervical plexus blocks are commonly used to facilitate carotid endarterectomy (CEA) in the awake patient. These blocks can be divided into superficial, intermediate, and deep blocks by their relation to the fasciae of the neck. We hypothesized that the depth of block would have a significant impact on phrenic nerve blockade and consequently hemi-diaphragmatic motion.

methodsWe enrolled 45 patients in an observer blinded randomized controlled trial, scheduled for elective, awake CEA. Patients received either deep, intermediate, or superficial cervical plexus blocks, using 20 mL of 0.5% ropivacaine mixed with an MRI contrast agent. Before and after placement of the block, transabdominal ultrasound measurements of diaphragmatic movement were performed. Patients underwent MRI of the neck to evaluate spread of the injectate, as well as lung function measurements. The primary outcome was ipsilateral difference of hemi-diaphragmatic motion during forced inspiration between study groups.

resultsPostoperatively, forced inspiration movement of the ipsilateral diaphragm (4.34±1.06, 3.86±1.24, 2.04±1.20 (mean in cm±SD for superficial, intermediate and deep, respectively)) was statistically different between block groups (p<0.001). Differences were also seen during normal inspiration. Lung function, oxygen saturation, complication rates, and patient satisfaction did not differ. MRI studies indicated pronounced permeation across the superficial fascia, but nevertheless easily distinguishable spread of injectate within the targeted compartments.

conclusionsWe studied the characteristics and side effects of cervical plexus blocks by depth of injection. Diaphragmatic dysfunction was most pronounced in the deep cervical plexus block group. TRIAL REGISTRATION NUMBER: EudraCT 2017-001300-30.

Indexed as

Anesthesia, ConductionCervical Plexus BlockAnesthetics, LocalHumansRopivacaineUltrasonography, InterventionalAnesthetics, LocalRopivacainemultimodal imagingnerve blockregional anesthesia

Identifiers

PMID35012992
PMCPMC8867263
OpenAlexW4205155320

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Registered trials

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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.