{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T09:20:33Z","timestamp":1764235233502,"version":"3.46.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010398","name":"Metro South Health","doi-asserted-by":"publisher","award":["RSS_2023_102"],"award-info":[{"award-number":["RSS_2023_102"]}],"id":[{"id":"10.13039\/100010398","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002076","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","award":["EMEG\u2010030R38\u20102022\u2010TSAO"],"award-info":[{"award-number":["EMEG\u2010030R38\u20102022\u2010TSAO"]}],"id":[{"id":"10.13039\/100002076","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australas J Ultrason Med"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ultrasound\u2010guided supraclavicular block (UGSCB) can provide upper limb regional anaesthesia and is an emerging technique in the emergency department (ED). A potential adverse event is phrenic nerve block causing hemi\u2010diaphragmatic paresis, but its incidence in ED remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This nested prospective cohort study evaluated adult patients (\u2265\u200918\u2009years) without lung disease who underwent UGSCB for closed reduction of distal radius fractures. UGSCB was performed on the injured side using a two\u2010injection method with 20\u2009mL of 0.75% ropivacaine. The primary outcome was ipsilateral diaphragmatic excursion assessed using bedside ultrasound dynamic imaging before and 30\u2009min post\u2010UGSCB during three respiratory manoeuvres: tidal volume breathing (TV), deep inspiration (DI) and sniff inspiration (SI). Diaphragmatic paralysis was defined as \u2265\u200975% reduction in diaphragmatic excursion, averaged across the three manoeuvres. Secondary outcomes included vital signs including respiratory rate, oxygen saturations, blood pressure and heart rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen participants were evaluated. UGSCB was associated with reduced ipsilateral diaphragmatic excursion for TV (mean difference [MD] 1.21\u2009cm, 95% confidence interval [95% CI] 0.69\u20131.75), DI (MD 3.37, 95% CI 2.15 to 4.59) and SI manoeuvres (MD 1.95, 95% CI 1.23 to 2.68). Diaphragmatic paralysis was observed in 10 participants (62.5%). No significant changes in vital signs were observed following UGSCB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ED physician\u2010performed UGSCB using a two\u2010injection technique was commonly associated with hemi\u2010diaphragmatic paresis, likely due to concomitant phrenic nerve block. However, this was not associated with respiratory or haemodynamic compromise in adult patients without lung disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajum.70030","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T07:24:38Z","timestamp":1762413878000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ipsilateral Phrenic Nerve Paresis Associated With Ultrasound\u2010Guided Supraclavicular Block: A Prospective Cohort Study"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4418-5441","authenticated-orcid":false,"given":"Henry","family":"Tsao","sequence":"first","affiliation":[{"name":"Emergency Department Redland Hospital  Cleveland Queensland Australia"},{"name":"Faculty of Medicine The University of Queensland  Herston Queensland Australia"},{"name":"Sonography Innovation and Research Group (SONAR group)  Southport Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Tang","sequence":"additional","affiliation":[{"name":"Emergency Department Redland Hospital  Cleveland Queensland Australia"},{"name":"Faculty of Medicine The University of Queensland  Herston Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Cureton","sequence":"additional","affiliation":[{"name":"Emergency Department Redland Hospital  Cleveland Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Maskell","sequence":"additional","affiliation":[{"name":"Emergency Department Redland Hospital  Cleveland Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Trembath","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Jones","sequence":"additional","affiliation":[{"name":"Sonography Innovation and Research Group (SONAR group)  Southport Queensland Australia"},{"name":"Emergency Department Logan Hospital  Meadowbrook Queensland Australia"},{"name":"Emergency Department Gold Coast University Hospital  Southport Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8579-445X","authenticated-orcid":false,"given":"Peter J.","family":"Snelling","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Herston Queensland Australia"},{"name":"Sonography Innovation and Research Group (SONAR group)  Southport Queensland Australia"},{"name":"Emergency Department Gold Coast University Hospital  Southport Queensland Australia"},{"name":"School of Medicine and Dentistry Griffith University  Southport Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2023.11.013"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.15441\/ceem.23.035"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2006.08.019"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000002878"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.09.011"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001305"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-022-01967-0"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12864"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-101728"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.4097\/kja.21028"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000795"},{"key":"e_1_2_11_13_1","first-page":"757","article-title":"Supraclavicular Brachial Plexus Block for Upper Limb Fracture Fixation:A Comparison of Nerve Stimulation, Ultrasound\u2010Guided Technique and a Combination of Both Techniques","volume":"37","author":"Omoregbe O. 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