Trial reportDrug design, development and therapy2026
Early Detection and Temporal Progression of Hemidiaphragmatic Paralysis After Supraclavicular Brachial Plexus Block with 20 mL vs 30 mL Ropivacaine: A Randomized Controlled Trial.
Trial report in Drug design, development and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Clinical Applicability of Early Hemidiaphragmatic Paralysis Monitoring After Supraclavicular Brachial Plexus Block [Letter].Drug design, development and therapy · 2026Article
- Electrophysiological Surrogates and Statistical Rigor in Dose-Response Trials: Comment on "Early Detection and Temporal Progression of Hemidiaphragmatic Paralysis After Supraclavicular Brachial Plexus Block with 20 mL vs 30 mL Ropivacaine" [Letter].Drug design, development and therapy · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Hemidiaphragmatic paralysis (HDP) is a recognized complication of supraclavicular brachial plexus block (SCBPB). This study aimed to compare the incidence and temporal progression of HDP following ultrasound-guided SCBPB with 20 mL versus 30 mL of 0.375% ropivacaine. Methods: Eighty-two patients undergoing removal of internal fixation devices in the upper extremities were randomly allocated to receive 20 mL (Group A) or 30 mL (Group B) of 0.375% ropivacaine for ultrasound-guided SCBPB. The diaphragmatic compound muscle action potential amplitude (Dia CMAP Amp) was measured before (T0) and 5 min (T1), 10 min (T2), 20 min (T3), and 30 min (T4) after SCBPB. The primary outcome was the incidence of HDP, defined as a ≥50% decrease in the Dia CMAP Amp from baseline. The secondary outcome was the Dia CMAP Amp at different times. Results: The risk of HDP was significantly greater in Group B than in Group A (RR=1.972, P=0.011). There was a significant time effect on the incidence of HDP (Wald's χ2=15.547, P=0.001); HDP could occur within 5 minutes, and the incidence of HDP at T2, T3 and T4 was 1.222 (P=0.046), 1.889 (P<0.001) and 1.944 P<0.001) times greater than that at T1, respectively. The Dia CMAP Amp following SCBPB was significantly different between the ropivacaine groups (Wald's χ2=5.517, p=0.019). Conclusion: HDP can be detected as early as 5 minutes after SCBPB, with incidence plateauing by 20 minutes while CMAP amplitude continues declining. Higher volume (30 mL) nearly doubles HDP risk (RR=1.972). Respiratory monitoring should begin within 5 minutes of block placement.
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