Evidence map›Paper›PMID 40130089›Full record

ArticleCureus2025

The Role of Desflurane in the Functional Outcomes Among Spinal Cord Injury Patients Undergoing Upper Extremity Nerve Transfer Procedures.

Muhammad I Kaleem, Arbi B Abdallah, Saad Javeed, Sahasraara Hemanth, Daniel M Hafez, Jacob K Greenberg, Wilson Z Ray, Umeshkumar Athiraman

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Muhammad I KaleemNeurological Surgery, Washington University School of Medicine, St. Louis, USA.
Arbi B AbdallahAnesthesiology, Washington University School of Medicine, St. Louis, USA.
Saad JaveedNeurological Surgery, Washington University School of Medicine, St. Louis, USA.
Sahasraara HemanthAnesthesiology, Washington University School of Medicine, St. Louis, USA.
Daniel M HafezNeurological Surgery, Washington University School of Medicine, St. Louis, USA.
Jacob K GreenbergNeurological Surgery, Washington University School of Medicine, St. Louis, USA.
Wilson Z RayNeurological Surgery, Washington University School of Medicine, St. Louis, USA.
Umeshkumar AthiramanAnesthesiology, Washington University School of Medicine, St. Louis, USA.

Funding

Molecular mechanisms underlying isoflurane conditioning-induced neurovascular protection in subarachnoid hemorrhageK08NS125038 · NINDS · WASHINGTON UNIVERSITY · PI Umeshkumar Athiraman · 2022 to 2026
$891k
NINDS NIH HHS K08 NS125038
6 · The paper itself

Abstract

Background and objective While several experimental studies have demonstrated the neuroprotective role of volatile anesthetics after spinal cord injury (SCI), the impact of volatile anesthetics on improving neurologic outcomes in spinal cord-injured patients is not known. Hence, this study aimed to examine the impact of volatile anesthetics on functional outcomes of chronic cervical SCI patients undergoing peripheral nerve transfer procedures. Methods We conducted a retrospective analysis involving adult patients with cervical SCI and upper extremity paralysis undergoing nerve transfer procedures between September 1, 2015, and January 31, 2019. The principal outcome measured was the motor strength of the reinnervated muscle targets assessed per the Medical Research Council (MRC) scale graded from 0 to 5. Secondary outcomes included Disabilities of Arm, Shoulder, and Hand (DASH); Sollerman Hand Function Test (SHFT); and Michigan Hand Questionnaire (MHQ) scores. Univariate analysis and logistic regression were performed to examine the association between the volatile anesthetics (sevoflurane, desflurane) used during the nerve transfer surgery with the improvement in muscle strength examined up to 48 months postoperatively. Results A total of 13 tetraplegic patients with a mean age of 39.2 ± 15.9 years were included in this study. We found that the desflurane group (n=22 muscles) had greater median motor strength than the sevoflurane group (n=60 muscles) towards the final follow-up when the desflurane group had median motor strength of 3 [interquartile range (IQR): 1-4] and sevoflurane group had a median motor strength of 1 (IQR: 0-2.25); p=0.014. However, there was no statistically significant difference between the two groups in the DASH, SHFT, and MHQ scores. Logistic regression analysis showed that type of nerve transfer and preop AIS (ASIA Impairment Scale) grade were significantly associated with higher odds of improvement of motor power by at least 2 grades. Conclusions Our preliminary data show an association between desflurane use and improved motor strength in SCI patients undergoing peripheral nerve transfers. The data suggest that volatile anesthetic conditioning-induced protection observed in preclinical studies may also exist in SCI patients. This will need to be validated in a larger sample size. Examining the therapeutic window, and identifying the molecular mechanisms underlying volatile anesthetic conditioning-induced protection are warranted to aid future translational studies.

Indexed as

functional outcomesneuroprotectionperipheral nerve transfersspinal cord injuryvolatile anesthetics

Identifiers

PMID40130089
PMCPMC11931669

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.