{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:29:27Z","timestamp":1791908967161,"version":"4.3.4"},"reference-count":35,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"accepted":{"date-parts":[[2018,6,6]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background and objectives<\/jats:title>\n                  <jats:p>Diaphragmatic paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30\u2009mL (Group B) 0.375% ropivacaine. The latency and amplitude of diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1\u00b12.7 min) than in Group B (5.4 \u00b1 2.8 min; p&lt;0.05). The mean amplitude of the diaphragm CMAP was significantly lower in Group B than in Group A (p=0.03). The changes in FVC (Group A, \u2212 8.1% vs Group B, \u221216.5%), FVC% (Group A, \u22128.0% vs Group B, \u221217.1%), and FEV1 (Group A, \u22129.5% vs Group B, \u221215.2%) from pre-SCBPB to post-SCBPB were significantly less in Group A than in Group B (all p=0.03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The incidence rates of phrenic nerve palsy and diaphragm paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ChiCTR-IND-17012166.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2018-000014","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T14:04:06Z","timestamp":1547474646000},"page":"69-75","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Effect of local anesthetic volume (20 mL vs 30 mL ropivacaine) on electromyography of the diaphragm and pulmonary function after ultrasound-guided supraclavicular brachial plexus block: a randomized controlled trial"],"prefix":"10.1136","volume":"44","author":[{"given":"Xiuxia","family":"Bao","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The 98th Clinical College of PLA, Anhui Medical University, Huzhou, China"},{"name":"Department of Anesthesiology, The First Affiliated Hospital Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanjuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The 98th Clinical College of PLA, Anhui Medical University, Huzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haorong","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The 98th Clinical College of PLA, Anhui Medical University, Huzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The 98th 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