Role of perioperative diaphragmatic point-of-care ultrasound in assessing postoperative pulmonary…

Cohort studyJournal of anaesthesiology, clinical pharmacology· 2026

Role of perioperative diaphragmatic point-of-care ultrasound in assessing postoperative pulmonary complications in brachial plexus repair surgeries with preexisting hemidiaphragm paresis: A prospective observational study.

Singam Geetha, Kavitha Jayaram, Padmaja Durga

Perioperative MedicineCohort studyDiagnosisQ2IF 1.0

Postoperative pulmonary complications were rare after brachial plexus repair despite preexisting hemidiaphragm paresis

Role of perioperative diaphragmatic point-of-care ultrasound in assessing postoperative pulmonary complications in brachial plexus repair surgeries with preexisting hemidiaphragm paresis: A prospective observational study.

Singam Geetha … Padmaja Durga

Journal of anaesthesiology, clinical pharmacology · 2026 · Q2 in Anesthesiology

Background

A brachial plexus injury (brachial plexus injury) with phrenic nerve involvement causes hemidiaphragm paresis and subclinical respiratory problems.

Methods

This prospective observational study recruited 60 patients with chronic hemidiaphragm paresis undergoing brachial plexus injury repair surgeries under propofol-dexmedetomidine total intravenous anesthesia (total intravenous anesthesia) without muscle relaxants.

n = 60 patients

3.33%

Results

3.33%

normal recovery, just 2 of 60 patients needed extra oxygen after surgery

n = 60 patients

More results

All 60 patients exhibited lower diaphragm parameters in the affected side than the normal side ( P < 0.05) (100% diaphragm dysfunction incidence) except for diaphragm thickness during expiration preoperatively, reflecting paresis.

More results

Postoperatively, the normal hemidiaphragm showed a significant fall in diaphragm excursion during deep breathing ( P = 0.042), diaphragm thickness during inspiration ( P = 0.001), and diaphragm thickness fraction ( P = 0.031) but remained near normal, implying no new dysfunction.

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Conclusion · 1 of 2

Perioperative diaphragmatic point-of-care ultrasound reliably assesses perioperative diaphragmatic dysfunction in brachial plexus repair surgeries with preexisting hemidiaphragm paresis.

Conclusion · 2 of 2

postoperative pulmonary complication incidence is low with propofol-dexmedetomidine total intravenous anesthesia and meticulous microsurgical techniques, which preserve diaphragm integrity and promote safe extubation under point-of-care ultrasound guidance, despite chronic paresis, but large trials are needed.

Role of perioperative diaphragmatic point-of-care ultrasound in assessing postoperative pulmonary complications in brachial plexus repair surgeries with preexisting hemidiaphragm paresis: A prospective observational study.

Role of perioperative diaphragmatic point-of-care ultrasound in assessing postoperative pulmonary complications in brachial plexus repair surgeries with preexisting hemidiaphragm paresis: A prospective observational study.

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