Evidence map›Paper›PMID 39654085›Full record

Trial reportKorean journal of anesthesiology2025

Costoclavicular block as a diaphragm-sparing nerve block for shoulder surgery: a randomized controlled trial.

Youngin Lee, Seunguk Bang, Jihyun Chung, Min Suk Chae, Jungwon Shin

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Korean journal of anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07671352 (Comparative Evaluation of Diaphragmatic Function Following Interscalene, Anterior Suprascapular, and Costoclavicular Nerve Blocks in Shoulder Surgery), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT07671352 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Comparative Evaluation of Diaphragmatic Function Following Interscalene, Anterior Suprascapular, and Costoclavicular Nerve Blocks in Shoulder Surgery

TypeinterventionalSponsorMenoufia UniversityRan2026 to 2027Enrolled75ConditionsHemidiaphragmatic Paralysis, Postoperative Pain, Shoulder Surgery, Brachial Plexus BlockArmsUltrasound-guided interscalene brachial plexus block, Ultrasound-guided suprascapular nerve block, Ultrasound-guided costoclavicular brachial plexus block
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Review
  6. Review
  7. 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

5 authors.

Youngin LeeDepartment of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Seunguk BangDepartment of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Jihyun ChungDepartment of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Min Suk ChaeDepartment of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Jungwon ShinDepartment of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDistal nerve block approaches have been explored to reduce hemidiaphragmatic paresis (HDP) more effectively than interscalene block (ISB). However, these approaches are associated with a high incidence of HDP. The costoclavicular block (CCB) provides effective analgesia while reducing HDP. Here, we hypothesized that CCB would decrease the incidence of HDP compared to ISB while still providing effective pain relief after surgery.

methodsSeventy patients who underwent arthroscopic rotator cuff repair were randomly allocated to receive either ultrasound-guided CCB (n = 35) or ISB (n = 35). Each group received 0.2% ropivacaine (20 ml CCB, 10 ml ISB). The primary outcome was the incidence of HDP, as measured using M-mode ultrasound. Diaphragmatic excursion, pulmonary function test results, opioid consumption, and pain scores were evaluated.

resultsSixty-six patients were included. CCB group had a significantly lower incidence of HDP than those in the ISB group (5.9% vs. 84.4%, P < 0.001). The diaphragmatic excursion reduction was significantly more in the ISB (3.87 cm) group than in the CCB (0.25 cm) group (P < 0.001). The decrease in forced vital capacity and forced expiratory volume in 1 s from baseline was significantly greater in the ISB. There was no significant difference in opioid consumption between the two groups during the entire postoperative period.

conclusionsCompared with ISB, CCB significantly reduced the incidence of HDP while maintaining effective analgesia and causing less pulmonary function impairment. CCB may be a viable option for diaphragmatic-sparing analgesia after shoulder surgery.

Indexed as

Brachial Plexus BlockDiaphragmNerve BlockPostoperative PainRespiratory ParalysisShoulderAgedAnesthetics, LocalArthroscopyFemaleHumansMaleMiddle AgedRopivacaineUltrasonography, InterventionalAnesthetics, LocalRopivacaineAnalgesiaArthroscopyBrachial plexus blockCostoclavicularNerve blockPain, postoperativePhrenic nerve

Identifiers

PMID39654085
PMCPMC11834891

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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.