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Phrenic nerve block caused by interscalene brachial plexus block: breathing effects of different sites of injection

Overview of attention for article published in BMC Anesthesiology, July 2016
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Title
Phrenic nerve block caused by interscalene brachial plexus block: breathing effects of different sites of injection
Published in
BMC Anesthesiology, July 2016
DOI 10.1186/s12871-016-0218-x
Pubmed ID
Authors

Lars Bergmann, Stefan Martini, Miriam Kesselmeier, Wolf Armbruster, Thomas Notheisen, Michael Adamzik, Rϋdiger Eichholz

Abstract

Interscalene brachial plexus (ISB) block is often associated with phrenic nerve block and diaphragmatic paresis. The goal of our study was to test if the anterior or the posterior ultrasound guided approach of the ISB is associated with a lower incidence of phrenic nerve blocks and impaired lung function. This was a prospective, randomized and single-blinded study of 84 patients scheduled for elective shoulder surgery who fullfilled the inclusion and exclusion critereria. Patients were randomized in two groups to receive either the anterior (n = 42) or the posterior (n = 42) approach for ISB. Clinical data were recorded. In both groups patients received ISB with a total injection volume of 15 ml of ropivacaine 1 %. Spirometry was conducted at baseline (T0) and 30 min (T30) after accomplishing the block. Changes in spirometrical variables between T0 and T30 were investigated by Wilcoxon signed-rank test for each puncture approach. The temporal difference between the posterior and the anterior puncture approach groups were again analyzed by the Wilcoxon-Mann-Whitney test. The spirometric results showed a significant decrease in vital capacity, forced expiratory volume per second, and maximum nasal inspiratory breathing after the Interscalene brachial plexus block; indicating a phrenic nerve block (p <0.001, Wilcoxon signed-rank). A significant difference in the development of the spirometric parameters between the anterior and the posterior group could not be identified (Wilcoxon-Mann-Whitney test). Despite the changes in spirometry, no cases of dyspnea were reported. A different site of injection (anterior or posterior) did not show an effect in reducing the cervical block spread of the local anesthetic and the incidence of phrenic nerve blocks during during ultrasound guided Interscalene brachial plexus block. Clinical breathing effects of phrenic nerve blocks are, however, usually well compensated, and subjective dyspnea did not occur in our patients. German Clinical Trials Register (DRKS number 00009908 , registered 26 January 2016).

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Mendeley readers

The data shown below were compiled from readership statistics for 88 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Germany 1 1%
Unknown 87 99%

Demographic breakdown

Readers by professional status Count As %
Other 17 19%
Student > Master 12 14%
Student > Doctoral Student 11 13%
Student > Postgraduate 8 9%
Researcher 7 8%
Other 17 19%
Unknown 16 18%
Readers by discipline Count As %
Medicine and Dentistry 51 58%
Nursing and Health Professions 9 10%
Biochemistry, Genetics and Molecular Biology 2 2%
Computer Science 2 2%
Neuroscience 2 2%
Other 4 5%
Unknown 18 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 April 2018.
All research outputs
#10,950,691
of 13,781,382 outputs
Outputs from BMC Anesthesiology
#579
of 863 outputs
Outputs of similar age
#185,884
of 263,088 outputs
Outputs of similar age from BMC Anesthesiology
#1
of 1 outputs
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So far Altmetric has tracked 863 research outputs from this source. They receive a mean Attention Score of 3.2. This one is in the 18th percentile – i.e., 18% of its peers scored the same or lower than it.
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