Evidence map›Paper›PMID 41168696›Full record

Trial reportBMC anesthesiology2025

Optimizing the superior trunk block for arthroscopic shoulder surgery: a randomized, double-blind comparison of low- vs. conventional-dose ropivacaine on anesthesia, analgesia, and diaphragmatic function.

Jinxiang Zhang, Yangyang Zhou, Peng Ding, Dongyu Zheng, Hongwei Zhu, Ming Gong, Liye Yang, Yonghua Li

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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.

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

2 citing papers in PubMed.

  1. Trial
  2. 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

8 authors.

Jinxiang Zhang *Department of Anesthesiology, Shanghai Changzheng Hospital, the Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China.
Yangyang Zhou *Department of Anesthesiology, Shanghai Changzheng Hospital, the Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China.
Peng Ding *Department of Anesthesiology, PLA No.983 Hospital, Tianjin, China.
Dongyu ZhengDepartment of Anesthesiology, Shanghai Changzheng Hospital, the Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China.
Hongwei ZhuDepartment of Anesthesiology, Shanghai Changzheng Hospital, the Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China.
Ming GongDepartment of Anesthesiology, Shanghai Changzheng Hospital, the Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China.
Liye YangDepartment of Anesthesiology, Shanghai Changzheng Hospital, the Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China. yangliye1204@163.com.
Yonghua LiDepartment of Anesthesiology, Shanghai Changzheng Hospital, the Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China. liyonghua1207@smmu.edu.cn.

Funding

Clinical research projects initiated by researchers in demonstration research wards 2023YJBF-PY11the Medical Innovation Research Project of Shanghai Science and Technology Commission 21Y11906400the second round of the Shanghai Shenkang Hospital Development Centre's "Three Year Action Plan to Promote Clinical Skills and Clinical Innovation in Municipal Hospitals" research-oriented physician innovation and transformation ability training project SHDC2023CRD024
6 · The paper itself

Abstract

backgroundThe superior trunk block (STB) has been proposed as an alternative to interscalene block for reducing the risk of hemidiaphragmatic paralysis (HDP) while maintaining adequate analgesia. However, the optimal local anesthetic dosage for STB has not been established. This study aimed to evaluate whether a low dose of ropivacaine could effectively provide surgical anesthesia, reduce the incidence of complete and partial HDP, and improve anesthetic safety and patient comfort during shoulder arthroscopy.

methodsEighty-eight patients scheduled for shoulder arthroscopy were enrolled and randomly allocated in a 1:1 ratio to either a low-dose group (LD group; 10 mL of 0.25% ropivacaine) or a conventional-dose group (CD group; 15 mL of 0.5% ropivacaine). The primary outcome was the incidence of HDP assessed at 3 h post-block. Secondary outcomes included rates of successful surgical anesthesia, pain scores, opioid consumption, duration and onset time of the block, handgrip strength, and patient satisfaction.

resultsThe incidence of complete and partial HDP at 3 h post-STB was significantly lower in the LD group than in the CD group (31.8% vs. 84.1%, p < 0.001), with an absolute risk reduction of 52.3% (95% CI: 34.8% to 69.8%). All patients in both groups successfully underwent surgery without conversion to general anesthesia with tracheal intubation or requiring supplemental intraoperative analgesia. The overall patient satisfaction score was significantly higher in the LD group compared to the CD group (p = 0.003). However, patients in the LD group reported higher pain scores at 12 h post-block (p = 0.044), exhibited a shorter duration of sensory block (p = 0.001) compared to the CD group.

conclusionsThese findings indicate that a low-dose ropivacaine regimen (10 mL of 0.25%) for STB significantly reduces the incidence of HDP while still providing sufficient surgical anesthesia. However, this approach may be associated with reduced efficacy in postoperative analgesia.

trial registrationThis trial was registered at the Chinese Clinical Trial Registry (No. ChiCTR2000036608).

Indexed as

Anesthetics, LocalArthroscopyNerve BlockRopivacaineShoulderAdultAnalgesiaDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansMaleMiddle AgedPostoperative PainAnesthetics, LocalRopivacaineArthroscopic shoulder surgeryHemidiaphragmatic paralysisInterscalene brachial plexus blockRopivacaineSuperior trunk block

Identifiers

PMID41168696
PMCPMC12574075

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.