Evidence map›Paper›PMID 38105353›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024

Intraoperative ultrasound-guided pectoral nerve blocks for cardiac implantable device procedures.

Neel A Patel, David Lin, Bao Ha, Matthew C Hyman, Saman Nazarian, David S Frankel, Andrew E Epstein, Francis E Marchlinski, Timothy M Markman

Abstract read
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In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 22% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Letter to the editor: Re Intraoperative ultrasound-guided pectoral nerve blocks for cardiac implantable device procedures.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024
    Article
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

9 authors at 2 institutions in 1 country.

Neel A PatelCardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA.
David LinCardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA.
Bao HaDepartment of Anesthesiology, University of Pennsylvania, Philadelphia, PA, USA.
Matthew C HymanCardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA.
Saman NazarianCardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA.
David S FrankelCardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA.
Andrew E EpsteinCardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA.
Francis E MarchlinskiCardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA.
Timothy M MarkmanCardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA. Timothy.markman@pennmedicine.upenn.edu.ORCID http://orcid.org/0000-0002-3155-2006
University of Pennsylvania · USPenn Center for AIDS Research · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPectoral nerve (PECs) blocks are established regional anesthesia techniques that can provide analgesia to the anterior chest wall. Although commonly performed preoperatively by anesthesiologists, the feasibility of electrophysiologist-performed PECs blocks from within cardiac implantable electronic device (CIED) pockets at the time of implantation has not been established. The objective of this study is to assess the feasibility of routine PECs blocks performed by the electrophysiologist from within the exposed device pocket at the time of CIED procedures.

methodsPatients undergoing CIED procedures underwent a PECs I block (15 cc of 1% lidocaine/0.25% bupivacaine) injected between the pectoralis major and minor muscles guided by ultrasound placed in the device pocket, or PECs II block, which included a second injection (15 cc) between pectoralis minor and serratus anterior muscles. Postoperatively, pain was assessed on a numeric scale (0-10) at 1, 2, 4, and 24 h, and 2 weeks after the procedure.

resultsAmong 20 patients (age 65 ± 16 years, 70% male, 55% with history of chronic pain), PECs I (75%) and PECs II (25%) blocks were performed. The procedures were de novo implantation (n = 17) or device revision (n = 3). The average pain score in the first 4 h was 0.4 ± 0.8 and 0.3 ± 0.6 at 24 h after the procedure. During the 24-h postoperative period, 4 patients received opioids. Two patients were discharged with opioids for pain unrelated to the procedure.

conclusionsIntraoperative PECs blocks can be feasibly performed from within an exposed pocket at the time of CIED procedures with minimal postoperative pain.

Indexed as

Defibrillators, ImplantableNerve BlockThoracic NervesUltrasonography, InterventionalAgedAnesthetics, LocalBupivacaineFeasibility StudiesFemaleHumansLidocaineMaleMiddle AgedPacemaker, ArtificialPain MeasurementPectoralis MusclesAnesthetics, LocalBupivacaineLidocaineCardiac implantable electronic devicePECs blocksPectoral nerve blocksPostoperative painRegional anesthesia

Identifiers

PMID38105353
OpenAlexW4389868018

What OpenQuestion holds

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Registered trials

None linked

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.