{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:20:20Z","timestamp":1787840420382,"version":"build-2784847793"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aim:<\/jats:title>\n Phrenic nerve is usually involved while administering intersalene brachial plexus block (ISBPB), resulting in partial\/total hemidiaphragmatic paresis (Hdp) that can affect respiratory mechanics. The aim was to determine the incidence of diaphragm excursion before and after administration of ISBPB using ultrasonography.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Sixty-two patients received ISBPB for anesthesia in the shoulder region who consented to be a part of a prospective observational study. Pre- and postblock values for diaphragmatic excursions were recorded for quiet and deep breathing (DB) using a 3\u20135 MHz ultrasound (USG) probe to calculate the percentage change. The volume of local anesthesia (LA) was in the range of 10\u201340 ml. Categorical data were analyzed using the Chi-square test and correlated with continuous data using c. The level of significance was\n P<\/jats:italic>\n < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In the group of patients who received 10\u201320 mL of local anesthetic, 30% of patients had total Hdp, whereas 66.7% had total Hdp upon receiving 20\u201330 mL of local anesthetic (\n P<\/jats:italic>\n = 0.015, Chi-square test) during quiet breathing (QB). Similarly, during DB, total Hdp was observed in 20% of patients who received 10\u201320 mL local anesthetic, whereas it was significantly higher in 47.6% of patients who received 20\u201330 mL of local anesthetic (\n P<\/jats:italic>\n = 0.018, Chi-square test). A significant positive moderate correlation was observed between volume of LA and diaphragmatic excursions during QB (Spearman\u2019s correlation coefficient = 0.571,\n P<\/jats:italic>\n = 0.001) as well as during DB (Spearman\u2019s correlation coefficient = 0.556,\n P<\/jats:italic>\n = 0.001) were the additional outcome measures. Only two patients developed complications and paradoxical movement was seen in 77.4% of patients.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n An increase in the volume of LA increased the incidence of Hdp and total diaphragmatic paralysis.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aam.aam_154_25","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T12:01:05Z","timestamp":1755691265000},"page":"568-573","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-guided Assessment of Phrenic Nerve Involvement after Interscalene Brachial Plexus Block"],"prefix":"10.4103","volume":"25","author":[{"given":"Jyothi","family":"Biradar","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M V","family":"Eeshwar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, AIIMS, Mangalgiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laxmi","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogesh","family":"Gaude","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Manipal Hospitals, Goa, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souvik","family":"Chaudhuri","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Kasturba Medical College, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"R1-20260504","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1136\/rapm-00115550-199621021-00107","article-title":"The pre-emptive analgesic effect of interscalene blockprior to shoulder surgery (scientific poster)","volume":"21","author":"Salcedo","year":"1996","journal-title":"Reg Anesth"},{"key":"R2-20260504","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1213\/00000539-199203000-00006","article-title":"Hemidiaphragmatic paresis during interscalene brachial plexus block: Effects on pulmonary function and chest wall mechanics","volume":"74","author":"Urmey","year":"1992","journal-title":"Anesth Analg"},{"key":"R3-20260504","first-page":"962","article-title":"Effect of hemidiaphragmatic paresis caused by interscalene brachial plexus block on breathing pattern, chest wall mechanics, and arterial blood gases","volume":"81","author":"Fujimura","year":"1995","journal-title":"Anesth Analg"},{"key":"R4-20260504","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/00115550-199924030-00009","article-title":"Phrenic nerve block caused by interscalene brachial plexus block: Effects of digital pressure and a low volume of local anesthetic","volume":"24","author":"Sala-Blanch","year":"1999","journal-title":"Reg Anesth Pain Med"},{"key":"R5-20260504","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1097\/AAP.0b013e3181bfbd83","article-title":"Hemidiaphragmatic paresis can be avoided in ultrasound-guided supraclavicular brachial plexus block","volume":"34","author":"Renes","year":"2009","journal-title":"Reg Anesth Pain Med"},{"key":"R6-20260504","first-page":"152","article-title":"Phrenic nerve block after interscalene brachial plexus block. 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