Evidence map›Paper›PMID 42414111›Full record

Trial reportBritish journal of anaesthesia2026

Effects of fentanyl on diaphragm muscle force in patients undergoing knee arthroplasty: a randomised double-blind clinical trial.

Heather M Gransee, Matthew W Urban, Beth A Martin, Anita D Stoltenberg, Kate M Knoll, Sepideh Jahanian, Brenda K Anderson, Jason K Panchamia, Darrell R Schroeder, Carlos B Mantilla

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in British journal of anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05856136 (Investigation of the Effects of Opioid Exposure on the Ability of the Diaphragm Muscle to Generate Higher Force Behaviors), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT05856136 phase4recruitingnot on this map

Investigation of the Effects of Opioid Exposure on the Ability of the Diaphragm Muscle to Generate Higher Force Behaviors

TypeinterventionalSponsorMayo ClinicRan2023 to 2027Enrolled69ConditionsRespiratory Function Loss, Respiratory ComplicationArmsFentanyl Injection
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Heather M GranseeDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Matthew W UrbanDepartment of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Beth A MartinDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Anita D StoltenbergDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Kate M KnollDepartment of Radiology, Mayo Clinic, Rochester, MN, USA.
Sepideh JahanianDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Brenda K AndersonDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Jason K PanchamiaDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Darrell R SchroederDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
Carlos B MantillaDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA. Electronic address: mantilla.carlos@mayo.edu.

Funding

Prediction and early recognition of opioid-induced respiratory depressionR21DA055848 · NIDA · MAYO CLINIC ROCHESTER · PI MANTILLA, CARLOS B · 2022 to 2023
$437k
NIDA NIH HHS R21 DA055848
6 · The paper itself

Abstract

backgroundOpioids exert important negative effects on respiration, evident across a range of behaviours. The present study evaluated whether fentanyl administration decreases diaphragm muscle forces across levels of inspiratory loading in adult patients undergoing elective knee arthroplasty surgery.

methodsAdult patients undergoing elective knee arthroplasty with no pulmonary pathology were randomly assigned to a fentanyl dose (25, 50, or 100 μg) in a double-blind, single-institution clinical trial. Ultrasound-based shear wave elastography was used to measure diaphragm Young's modulus (E). The primary outcome was change in the difference in E achieved across levels of inspiratory loading (E range) before randomisation and 10 min post-fentanyl (ΔE range) as a measure of fentanyl-induced changes in diaphragm force-generating capacity.

resultsSixty-nine patients (average age 69 yr) were randomised, with final data analysis in 22, 22, and 19 patients from the 25, 50, and 100 μg groups, respectively. The ΔE range was compared across dose groups using analysis of covariance, with the pretreatment E range included as the covariate. The estimated treatment effect (95% confidence interval) for 50 μg vs 25 μg, and for 100 μg vs 25 μg was -0.7 (-9.5, 8.1) and -5.3 (-14.1, 3.6), respectively. There was no statistically significant effect of fentanyl on ΔE range (P=0.432).

conclusionsFentanyl did not reduce the E range generated by the diaphragm muscle during inspiratory pressure-threshold loading, possibly reflecting relatively low levels of inspiratory loading or the presence of a fentanyl effect even at the lowest dose used (25 μg) in this older patient population. CLINICAL TRIALS ID: NCT05856136.

Indexed as

Analgesics, OpioidArthroplasty, Replacement, KneeDiaphragmFentanylAgedAged, 80 and overDose-Response Relationship, DrugDouble-Blind MethodElasticity Imaging TechniquesFemaleHumansMaleMiddle AgedAnalgesics, OpioidFentanyldiaphragm muscleforceopioidrespiratoryshear-wave elastography

Identifiers

PMID42414111
PMCPMC13383501

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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.