Hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial

Abstract Costoclavicular brachial plexus block is emerging as a promising infraclavicular approach performed just below the clavicle. However, there are relatively little data regarding the hemidiaphragmatic paralysis (HDP) compared to the commonly performed supraclavicular block. We hypothesized th...

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Autores principales:	Boohwi Hong, Soomin Lee, Chahyun Oh, Seyeon Park, Hyun Rhim, Kuhee Jeong, Woosuk Chung, Sunyeul Lee, ChaeSeong Lim, Yong-Sup Shin
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2a5726bc53394125b92324a3e930425e
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spelling	oai:doaj.org-article:2a5726bc53394125b92324a3e930425e2021-12-02T18:48:01ZHemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial10.1038/s41598-021-97843-x2045-2322https://doaj.org/article/2a5726bc53394125b92324a3e930425e2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97843-xhttps://doaj.org/toc/2045-2322Abstract Costoclavicular brachial plexus block is emerging as a promising infraclavicular approach performed just below the clavicle. However, there are relatively little data regarding the hemidiaphragmatic paralysis (HDP) compared to the commonly performed supraclavicular block. We hypothesized that the incidence of HDP in costoclavicular block is lower than supraclavicular block like classical infraclavicular approach. Eighty patients were randomly assigned to ultrasound-guided supraclavicular (group S) or costoclavicular (group C) block with 25 mL of local anesthetics (1:1 mixture of 1% lidocaine and 0.75% ropivacaine). The primary outcome was the incidence of HDP, defined as less than 20% of fractional change in the diaphragm thickness on ultrasound M-mode. Also, pulmonary function test and chest radiograph were assessed before and after the surgery. The incidence of HDP was 4/35 (11.4%) in the group C and 19/40 (47.5%) in the group S (risk difference, − 36%; 95% CI − 54 to − 17%; P = 0.002). The mean (SD) change of DTF values were 30.3% (44.0) and 56.9% (39.3) in the group C and S, respectively (difference in means, − 26.6%; 95% CI − 45.8 to − 7.4%; P = 0.007). The pulmonary function was more preserved in group C than in group S. The determined diagnostic cut off value of the diaphragm elevation on chest radiograph was 29 mm. Despite the very contiguous location of the two approaches around the clavicle, costoclavicular block can significantly reduce the risk of HDP compared with supraclavicular block.Boohwi HongSoomin LeeChahyun OhSeyeon ParkHyun RhimKuhee JeongWoosuk ChungSunyeul LeeChaeSeong LimYong-Sup ShinNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Boohwi Hong Soomin Lee Chahyun Oh Seyeon Park Hyun Rhim Kuhee Jeong Woosuk Chung Sunyeul Lee ChaeSeong Lim Yong-Sup Shin Hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial
description	Abstract Costoclavicular brachial plexus block is emerging as a promising infraclavicular approach performed just below the clavicle. However, there are relatively little data regarding the hemidiaphragmatic paralysis (HDP) compared to the commonly performed supraclavicular block. We hypothesized that the incidence of HDP in costoclavicular block is lower than supraclavicular block like classical infraclavicular approach. Eighty patients were randomly assigned to ultrasound-guided supraclavicular (group S) or costoclavicular (group C) block with 25 mL of local anesthetics (1:1 mixture of 1% lidocaine and 0.75% ropivacaine). The primary outcome was the incidence of HDP, defined as less than 20% of fractional change in the diaphragm thickness on ultrasound M-mode. Also, pulmonary function test and chest radiograph were assessed before and after the surgery. The incidence of HDP was 4/35 (11.4%) in the group C and 19/40 (47.5%) in the group S (risk difference, − 36%; 95% CI − 54 to − 17%; P = 0.002). The mean (SD) change of DTF values were 30.3% (44.0) and 56.9% (39.3) in the group C and S, respectively (difference in means, − 26.6%; 95% CI − 45.8 to − 7.4%; P = 0.007). The pulmonary function was more preserved in group C than in group S. The determined diagnostic cut off value of the diaphragm elevation on chest radiograph was 29 mm. Despite the very contiguous location of the two approaches around the clavicle, costoclavicular block can significantly reduce the risk of HDP compared with supraclavicular block.
format	article
author	Boohwi Hong Soomin Lee Chahyun Oh Seyeon Park Hyun Rhim Kuhee Jeong Woosuk Chung Sunyeul Lee ChaeSeong Lim Yong-Sup Shin
author_facet	Boohwi Hong Soomin Lee Chahyun Oh Seyeon Park Hyun Rhim Kuhee Jeong Woosuk Chung Sunyeul Lee ChaeSeong Lim Yong-Sup Shin
author_sort	Boohwi Hong
title	Hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial
title_short	Hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial
title_full	Hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial
title_fullStr	Hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial
title_full_unstemmed	Hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial
title_sort	hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2a5726bc53394125b92324a3e930425e
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Hemidiaphragmatic paralysis following costoclavicular versus supraclavicular brachial plexus block: a randomized controlled trial

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