Outcomes measurement
postoperative pain
PARTIAL PARALYSIS, SECONDARY, DIAPHRAGM
The primary observation outcome was the time of first use of analgesics. Whenever postoperative pain scores were above 4, 50 mg parecoxib sodium was administered intravenously.As a secondary outcome, the effect of the block was measured at 30 min in three areas: sternoclavicular joint, midclavicular and acromioclavicular joint. Four levels were established: zero indicated no decreased sensation, one indicated decreased sensitivity to puncture, two indicated no sensitivity to puncture, and three indicated no tactile sensitivity. Values two and three were assessed as correct blocks. Modified Bromage scale (MBS) scores [Real-time M-mode ultrasonography of the hemidiaphragmDiaphragmatic movement was evaluated by real-time M-mode ultrasonography of the hemidiaphragm (sigh test), and diaphragm movement was reduced by 71%, suggesting partial paralysis of the diaphragm.
Diaphragm movement is 6.63 cm from baseline measured by M-mode ultrasound before the block.Diaphragm movement is 1.92 cm from baseline measured by M-mode ultrasound 30 min after the block.