{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T07:50:26Z","timestamp":1773474626969,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T00:00:00Z","timestamp":1773446400000},"content-version":"vor","delay-in-days":72,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For pediatric pectus excavatum, the standard treatment is minimally invasive repair of pectus excavatum (MIRPE). A major challenge, however, is the severe postoperative pain. Although ultrasound\u2010guided intercostal nerve block (UINB) offers effective analgesia, the technique\u2019s complexity and associated safety concerns are significant barriers, deterring its routine use. Modified intercostal nerve block (MINB) is effective in adult thoracic surgery but unvalidated in pediatric MIRPE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate MINB\u2019s noninferiority to UINB for postoperative analgesia and safety in children undergoing MIRPE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single\u2010center randomized noninferiority trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy\u2010six ASA I\u2013II pediatric patients (8\u201318\u2009years) scheduled for single\u2010bar MIRPE were 1:1 randomized to the MINB or UINB group. Primary outcome includes 24\u2010h postoperative coughing visual analog scale (VAS) score (noninferiority margin \u0394\u2009=\u20091.0). Secondary outcomes include resting\/coughing VAS scores at 3, 6, 9, 12, 24, and 48\u2009h postoperatively; procedure duration; local anesthetic dose; needle complications; opioid consumption; rescue analgesia; and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean difference in 24\u2010h coughing VAS (MINB\u2010UINB) score was \u22120.02 (95% CI: \u22120.85 to 0.80), confirming noninferiority of MINB (upper 95% CI limit 0.80\u2009&lt;\u2009noninferiority margin \u0394\u2009=\u20091.0). MINB reduced procedure time by 65% (4.6\u2009\u00b1\u20091.3 vs. 13.2\u2009\u00b1\u20091.6\u2009min;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), decreased ropivacaine dose by 19% (50.0\u2009\u00b1\u20090.0 vs. 61.9\u2009\u00b1\u20094.6\u2009mg;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), shortened anesthesia duration (119.6\u2009\u00b1\u200918.3 vs. 131.8\u2009\u00b1\u200914.6\u2009min;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002), and eliminated vascular injuries (0% vs. 16.2%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.025). All other outcomes demonstrated no statistically significant differences in the comparisons between the groups (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For children undergoing single\u2010bar MIRPE, MINB provides noninferior analgesia to UINB with critical advantages: 65% faster placement, 19% lower ropivacaine dose, reduced anesthesia duration, and elimination of vascular injuries. These findings suggest that MINB offers a valuable alternative to UINB for post\u2010MIRPE analgesia, as it appears to provide a more favorable balance between safety and efficiency.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trail Registration:<\/jats:bold>\n                      Chinese Clinical Trial Registry: ChiCTR2200057961\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/prm\/2183328","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T07:06:24Z","timestamp":1773471984000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Noninferiority of Ultrasound\u2010Guided Modified Intercostal Block to Traditional Approach for Analgesia After Minimally Invasive Repair of Pectus Excavatum in Children: A Randomized Trial"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9217-8669","authenticated-orcid":false,"given":"Ming-Wen","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0196-3042","authenticated-orcid":false,"given":"Xian-Lun","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4956-1533","authenticated-orcid":false,"given":"Yu-Zhu","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9595-610X","authenticated-orcid":false,"given":"Yin","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7266-2390","authenticated-orcid":false,"given":"Ying-Ying","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1306-8085","authenticated-orcid":false,"given":"Xin-Qi","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,14]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2018.05.010"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.10.017"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12988"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2023.09.016"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.01.025"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13942"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivaa151"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.09.024"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2020.01.023"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000449"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2021.12.051"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2022.12.011"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/5776833"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-020-04973-8"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2023.2187959"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.33394"},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-021-00975-y"},{"key":"e_1_2_12_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2024.07.016"},{"key":"e_1_2_12_19_2","first-page":"E565","article-title":"Anti-Nociceptive Effects of Dexmedetomidine Infusion Plus Modified Intercostal Nerve Block During Single-Port Thoracoscopic Lobectomy: A Double-Blind, Randomized Controlled Trial","volume":"24","author":"Cheng X. Q.","year":"2021","journal-title":"Pain Physician"},{"key":"e_1_2_12_20_2","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S405990"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2024.11.005"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009574.pub2"},{"key":"e_1_2_12_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001377"},{"key":"e_1_2_12_24_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004833"},{"key":"e_1_2_12_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew466"},{"key":"e_1_2_12_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.12.047"},{"key":"e_1_2_12_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2020.03.001"},{"key":"e_1_2_12_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-102305"},{"key":"e_1_2_12_29_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2021.09.014"},{"key":"e_1_2_12_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40981-018-0147-4"},{"key":"e_1_2_12_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.09.014"},{"key":"e_1_2_12_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2019.08.001"},{"key":"e_1_2_12_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn.2016.128"},{"key":"e_1_2_12_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-025-03193-w"},{"key":"e_1_2_12_35_2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-198606000-00011"},{"key":"e_1_2_12_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1987.tb04051.x"},{"key":"e_1_2_12_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)00173-X"},{"key":"e_1_2_12_38_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_100_19"},{"key":"e_1_2_12_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12823"},{"key":"e_1_2_12_40_2","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001833"}],"container-title":["Pain Research and Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/prm\/2183328","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/prm\/2183328","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/prm\/2183328","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T07:06:25Z","timestamp":1773471985000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/prm\/2183328"}},"subtitle":[],"editor":[{"given":"Hui","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/prm\/2183328"],"URL":"https:\/\/doi.org\/10.1155\/prm\/2183328","archive":["Portico"],"relation":{},"ISSN":["1203-6765","1918-1523"],"issn-type":[{"value":"1203-6765","type":"print"},{"value":"1918-1523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"2183328"}}