Research
Print page Print page
Switch language
Bispebjerg Hospital - a part of Copenhagen University Hospital
Published

Phrenic Nerve Block on Severe Post-Hepatectomy Shoulder Pain: A Randomized, Double-blind, Placebo-controlled, Pilot Study

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

APA

CBE

MLA

Vancouver

Author

Bak, Theis S ; Bøgevig, Søren ; Christensen, Amalie P ; Tollund, Carsten ; Hillingsø, Jens ; Aasvang, Eske K. / Phrenic Nerve Block on Severe Post-Hepatectomy Shoulder Pain : A Randomized, Double-blind, Placebo-controlled, Pilot Study. In: Acta Anaesthesiologica Scandinavica. 2021 ; Vol. 65, No. 9. pp. 1320-1328.

Bibtex

@article{3d6e082bd0c44974b33909552388d46a,
title = "Phrenic Nerve Block on Severe Post-Hepatectomy Shoulder Pain: A Randomized, Double-blind, Placebo-controlled, Pilot Study",
abstract = "BACKGROUND: Severe shoulder pain occurs frequently after surgery close to the diaphragm, potentially caused by referred pain via the ipsilateral phrenic nerve. We aimed to assess the analgesic effect of an ultrasound-guided phrenic nerve block on moderate to severe right-sided shoulder pain after open partial hepatectomy.METHODS: This was a randomized, double-blind, placebo-controlled, pilot study, comparing ultrasound-guided phrenic nerve block (ropivacaine 0.75 mg/mL) versus placebo (isotonic sodium chloride 0.9 mg/mL) on severe post-hepatectomy shoulder pain (NRS ≥6). Pre- and postoperative spirometry and arterial blood gas analyses were used to assess respiratory function. Subjects with chronic lung disease were excluded. Unfortunately, due to lack of funding, the trial was ended prematurely and therefore presented as a pilot study.RESULTS: One hundred and one subjects were screened for eligibility; 14 subjects were randomized, and two subjects were later excluded; thus, 12 subjects were analyzed with six in each group. A statistically significant difference in reduction in median pain intensity between groups was observed 15 minutes after phrenic nerve block ({"}ropivacaine first{"} ΔNRS: -6.0 [-6.0 to -3.0] vs. {"}saline first{"} ΔNRS: 0 [-6.0 to 1.0], P = .026). Spirometry results and arterial blood gas analyses were not clinically impacted by the block.CONCLUSIONS: Postoperative phrenic nerve block significantly reduced severe post-hepatectomy shoulder pain. Larger studies are warranted to confirm the lack of clinically relevant block-related impairment of respiratory function.",
keywords = "nerve block, pain, pain management, phrenic nerve, postoperative, referred",
author = "Bak, {Theis S} and S{\o}ren B{\o}gevig and Christensen, {Amalie P} and Carsten Tollund and Jens Hillings{\o} and Aasvang, {Eske K}",
note = "This article is protected by copyright. All rights reserved.",
year = "2021",
month = oct,
doi = "10.1111/aas.13928",
language = "English",
volume = "65",
pages = "1320--1328",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell Munksgaard",
number = "9",

}

RIS

TY - JOUR

T1 - Phrenic Nerve Block on Severe Post-Hepatectomy Shoulder Pain

T2 - A Randomized, Double-blind, Placebo-controlled, Pilot Study

AU - Bak, Theis S

AU - Bøgevig, Søren

AU - Christensen, Amalie P

AU - Tollund, Carsten

AU - Hillingsø, Jens

AU - Aasvang, Eske K

N1 - This article is protected by copyright. All rights reserved.

PY - 2021/10

Y1 - 2021/10

N2 - BACKGROUND: Severe shoulder pain occurs frequently after surgery close to the diaphragm, potentially caused by referred pain via the ipsilateral phrenic nerve. We aimed to assess the analgesic effect of an ultrasound-guided phrenic nerve block on moderate to severe right-sided shoulder pain after open partial hepatectomy.METHODS: This was a randomized, double-blind, placebo-controlled, pilot study, comparing ultrasound-guided phrenic nerve block (ropivacaine 0.75 mg/mL) versus placebo (isotonic sodium chloride 0.9 mg/mL) on severe post-hepatectomy shoulder pain (NRS ≥6). Pre- and postoperative spirometry and arterial blood gas analyses were used to assess respiratory function. Subjects with chronic lung disease were excluded. Unfortunately, due to lack of funding, the trial was ended prematurely and therefore presented as a pilot study.RESULTS: One hundred and one subjects were screened for eligibility; 14 subjects were randomized, and two subjects were later excluded; thus, 12 subjects were analyzed with six in each group. A statistically significant difference in reduction in median pain intensity between groups was observed 15 minutes after phrenic nerve block ("ropivacaine first" ΔNRS: -6.0 [-6.0 to -3.0] vs. "saline first" ΔNRS: 0 [-6.0 to 1.0], P = .026). Spirometry results and arterial blood gas analyses were not clinically impacted by the block.CONCLUSIONS: Postoperative phrenic nerve block significantly reduced severe post-hepatectomy shoulder pain. Larger studies are warranted to confirm the lack of clinically relevant block-related impairment of respiratory function.

AB - BACKGROUND: Severe shoulder pain occurs frequently after surgery close to the diaphragm, potentially caused by referred pain via the ipsilateral phrenic nerve. We aimed to assess the analgesic effect of an ultrasound-guided phrenic nerve block on moderate to severe right-sided shoulder pain after open partial hepatectomy.METHODS: This was a randomized, double-blind, placebo-controlled, pilot study, comparing ultrasound-guided phrenic nerve block (ropivacaine 0.75 mg/mL) versus placebo (isotonic sodium chloride 0.9 mg/mL) on severe post-hepatectomy shoulder pain (NRS ≥6). Pre- and postoperative spirometry and arterial blood gas analyses were used to assess respiratory function. Subjects with chronic lung disease were excluded. Unfortunately, due to lack of funding, the trial was ended prematurely and therefore presented as a pilot study.RESULTS: One hundred and one subjects were screened for eligibility; 14 subjects were randomized, and two subjects were later excluded; thus, 12 subjects were analyzed with six in each group. A statistically significant difference in reduction in median pain intensity between groups was observed 15 minutes after phrenic nerve block ("ropivacaine first" ΔNRS: -6.0 [-6.0 to -3.0] vs. "saline first" ΔNRS: 0 [-6.0 to 1.0], P = .026). Spirometry results and arterial blood gas analyses were not clinically impacted by the block.CONCLUSIONS: Postoperative phrenic nerve block significantly reduced severe post-hepatectomy shoulder pain. Larger studies are warranted to confirm the lack of clinically relevant block-related impairment of respiratory function.

KW - nerve block

KW - pain

KW - pain management

KW - phrenic nerve

KW - postoperative

KW - referred

UR - http://www.scopus.com/inward/record.url?scp=85107915662&partnerID=8YFLogxK

U2 - 10.1111/aas.13928

DO - 10.1111/aas.13928

M3 - Journal article

C2 - 34027992

VL - 65

SP - 1320

EP - 1328

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 9

ER -

ID: 65746222