The diaphragm-sparing effect of interscalene block with a low-volume of ropivacaine 0.1% vs. 0.5%%: A double-blind, controlled, randomised trial
Primary result · Hemidiaphragmatic dysfunction (decrease in diaphragm excursion >25% of baseline)Result — go to the resultRelative risk 0.24 95% CI 0.13–0.46Authors' conclusion
ISB with 7 ml of ropivacaine 0.1% is associated with a lower incidence of hemidiaphragmatic dysfunction, when compared with the same volume of ropivacaine 0.5%, but at the cost of potentially less effective postoperative analgesia.
Study context
- Population
- Patients undergoing shoulder arthroscopy under GA, tertiary university hospital
- Participants
- 60 patients
- Comparison
- Ultrasound-guided ISB with 7 ml ropivacaine 0.1% vs 0.5%
- Primary endpoint
- Incidence of hemidiaphragmatic dysfunction (decrease in diaphragm excursion >25% of baseline)
- Follow-up
- 30 min after ISB
Methodological detailssingle-centre
- Single-centre
Primary result
As reported in the abstract
Hemidiaphragmatic dysfunction (decrease in diaphragm excursion >25% of baseline)
Relative risk
0.24
95% CI 0.13–0.46
P < 0.001
Events by treatment group
Experimental vs Control
RR 0.24 (95% CI 0.13–0.46); P < 0.001
Secondary outcomes
Duration of effective analgesia · Log-rank test; not significant
P = 0.23
| Outcome | Mean difference in restricted mean survival time (h) (95% CI) | P value | |
|---|---|---|---|
| Duration of effective analgesia | −3.2 (−6.4 to 0.2) | P = 0.061 | |
| −10−505Difference, h (linear scale) |
| Outcome | Experimental | Control | P value |
|---|---|---|---|
| Hemidiaphragmatic paralysis (decrease in diaphragm excursion >75% of baseline) | 1 events | 25 events | P < 0.001 |
| Decrease in forced vital capacityMedian, % | −17 (IQR −23–-5) | −29 (IQR −42–-6) | P = 0.039 |
| Postoperative morphine requirement | 10 events | 3 events | P = 0.028 |
Original publication
The diaphragm-sparing effect of interscalene block with a low-volume of ropivacaine 0.1% vs. 0.5%%: A double-blind, controlled, randomised trial. Eur J Anaesthesiol Intensive Care. Published 23 April 2026. doi:10.
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