Ultrasound-guided medial branch of the superior laryngeal nerve block to reduce peri-operative opioids dosage and accelerate patient recovery

Qiuxiang Kang; Liang Wu; Yaohong Liu; Xu Zhang

doi:10.1371/journal.pone.0295127

Peer Review History

Original SubmissionJuly 17, 2023
2 Aug 2023 Decision Letter - Lalit Gupta, Editor PONE-D-23-20292Ultrasound-guided medial branch of the superior laryngeal nerve block to reduce peri-operative opioids dosage and accelerate patient recoveryPLOS ONE Dear Dr. Zhang, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== The introduction needs more context, including an overview of perioperative pain management importance, postoperative pain prevalence, and the significance of reducing opioid usage, with supporting statistics or evidence for multimodal analgesia. Define all abbreviations, particularly in the abstract and introduction. Clarify the sample size justification, whether based on primary outcomes. Expand the discussion to interpret results in the context of existing literature, discuss implications for perioperative pain management, study limitations, and future research directions. Provide a concise summary of key findings and their implications. Proofread the paper to improve overall quality by addressing grammar and typographical errors. ============================== Please submit your revised manuscript by Sep 16 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Lalit Gupta Academic Editor PLOS ONE Journal requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: I Don't Know ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Hi dear chief editor I studied your valuable manuscript by title"Ultrasound-guided medial branch of the superior laryngeal nerve block to reduce peri- operative opioids dosage and accelerate patient recovery" it have not Keyword, so write it on manuscript. Best regard The reviewer Reviewer #2: The introduction lacks context and background information. It would be helpful to include a brief overview of the importance of perioperative pain management, the prevalence of postoperative pain, and the significance of reducing opioid usage. Additionally, mention some statistics or evidence supporting the use of multimodal analgesia. Define all abbreviations used in the paper, especially in the abstract or introduction. Clarify the sample size justification and whether it was calculated based on the primary outcome measures. Expand the discussion section to interpret the results in the context of existing literature. Discuss the implications of your findings for perioperative pain management, limitations of the study, and potential future research directions. Provide a concise and clear summary of the key findings and their implications for clinical practice or further research. The paper contains several grammar and typographical errors. Consider proofreading the manuscript thoroughly to improve its overall quality. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0295127.r001
Revision 1
20 Aug 2023 Author Response We would like to thank you for your careful reading, helpful comments, and constructive suggestions, which has significantly improved the presentation of our manuscript. We have carefully considered all comments from the reviewers and revised our manuscript accordingly. The manuscript has also been double-checked, and the typos and grammar errors we found have been corrected. We marked out our responses to each comment from the reviewers in "Revised Manuscript with Track Changes" . We also responses to each comment in the file"Response to Reviewers". We believe that our responses have well addressed all concerns from the reviewers. We hope our revised manuscript can be accepted for publication. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0295127.r002
23 Oct 2023 Decision Letter - Lalit Gupta, Editor PONE-D-23-20292R1Ultrasound-guided medial branch of the superior laryngeal nerve block to reduce peri-operative opioids dosage and accelerate patient recoveryPLOS ONE Dear Dr. Zhang, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. = To make the study more clear, in the introduction, separate the primary and secondary goals. In the "materials and methods" section, move information about intervention doses and the control group to the randomization methods and rename it as "randomization." In Figure 1 (CONSORT), move it to the results section and add the numbers in each "allocated to group x." Also, clarify if blinding and allocation concealment were used. Clearly define primary and secondary outcomes, and mention any safety outcomes. Specify your statistical comparisons in advance, and address how missing data will be handled. Revise the sample size section to ensure it's clear whether Groups A and B from the pilot study are similar to this main study, rounding up the number to 18 if necessary. Finally, in Table 1, avoid performing formal tests at baseline since differences observed would be due to chance, so omit p-values Please submit your revised manuscript by Dec 07 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Lalit Gupta Academic Editor PLOS ONE Additional Editor Comments: This study explores how blocking the superior laryngeal nerve can reduce stress during general anesthesia. To make the study more clear, in the introduction, separate the primary and secondary goals. In the "materials and methods" section, move information about intervention doses and the control group to the randomization methods and rename it as "randomization." In Figure 1 (CONSORT), move it to the results section and add the numbers in each "allocated to group x." Also, clarify if blinding and allocation concealment were used. Clearly define primary and secondary outcomes, and mention any safety outcomes. Specify your statistical comparisons in advance, and address how missing data will be handled. Revise the sample size section to ensure it's clear whether Groups A and B from the pilot study are similar to this main study, rounding up the number to 18 if necessary. Finally, in Table 1, avoid performing formal tests at baseline since differences observed would be due to chance, so omit p-values. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: All comments have been addressed Reviewer #3: (No Response) ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #2: Yes Reviewer #3: No ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes Reviewer #3: No ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #2: Yes Reviewer #3: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #2: No Reviewer #3: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: (No Response) Reviewer #3: This is an interesting study looking at the effect of medial branch block of the superior laryngeal acne reduce stress response in patients under going general anesthesia. They are some fundamental points worth considering. In the introduction section at then end clearly distinguish the primary and secondary objectives. In the "materials and methods" section. Move the section definition of intervention dosages and control group etc… to random and control methods and actually rename that as "randomisatiom" Figure 1 CONSORT. This needs to be in results section. Figure 1: add the numbers in each "allocated to group x = " for all 4 groups Mention details blinding if any and allocation concealment. Outcomes. It's essential that outcomes are clearly defined. Both primary and secondary outcomes. Any safety outcomes? Stats methods. Pre-specify your comparisons otherwise if multiple comparisons was multiplicity adjusted for? Handling of missing data. Re-write the sample size section. It's unclear whether from the pilot study Group A and B are of similar interventions as in this main study? Round up the number to 18 as you cannot recruit 17.4 individuals. As this is a RCT report results in line with the CONSORT guideline statement. Table 1. As this is a randomised controlled trial, its not appropriate to perform formal tests at baseline. Any differences observed would indeed be due to chance. So omit p-values. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #2: No Reviewer #3: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0295127.r003
Revision 2
3 Nov 2023 Author Response Dear academic editor and reviewers We would like to thank you for your careful reading, helpful comments, and constructive suggestions, which has significantly improved the presentation of our manuscript. We have carefully considered all comments from the reviewers and revised our manuscript accordingly. The manuscript has also been double-checked, and the typos and grammar errors we found have been corrected. All abbreviations,particularly in the abstract and introduction have been defined. In the following section,we summarize our responses to each comment from the reviewers. We believe that our responses have well addressed all concerns from the reviewers. In our revisions, we paid specific attention to the comments 1)“To make the study more clear, in the introduction, separate the primary and secondary goals” and“Clearly define primary and secondary outcomes, and mention any safety outcomes” For these comment, We rewrote the last paragraph of the introduction as follows：“Our primary goal was to assess whether the medial branch block of the superior laryngeal nerve can reduce the stress response of patients undergoing general anesthesia during intubation. Our secondary goals were to assess whether the combination of other nerve blocks that can alleviate the incision pain can improve the perioperative pain of patients, thereby further reducing the dosage of opioids and speed up patient's postoperative recovery.” 2)“In the "materials and methods" section, move information about intervention doses and the control group to the randomization methods and rename it as "randomization." ” and“clarify if blinding and allocation concealment were used” For this comment,We have made corresponding modifications according to the suggestions, and wrote a section named “Randomization and blinding” 3)“In Figure 1 (CONSORT), move it to the results section and add the numbers in each "allocated to group x." ”. For this comment, We added the numbers in each "allocated to group x" in Figure 1 (CONSORT). However, if we move Figure 1 (CONSORT) to the results section, it will become Figure 2. Through reading related articles published in PLOS ONE, we found that there are also articles that put Figure 1(CONSORT) in Materials and methods section. So, we have retained Figure 1 (CONSORT) in this section. 4)“Specify your statistical comparisons in advance, and address how missing data will be handled.” and “Revise the sample size section to ensure it's clear whether Groups A and B from the pilot study are similar to this main study, rounding up the number to 18 if necessary” For this comment, We have made corresponding modifications according to the suggestions. Previously, due to a writing error, we wrote Group B instead of Group C. The largest difference was expected to be between groups A and C which are similar to this main study. The missing data were treated using the mean imputation method. 5)“avoid performing formal tests at baseline since differences observed would be due to chance, so omit p-values” For this comment, We have made corresponding modifications according to the suggestions. All the changes are marked out in the paper ”Revised Manuscript with Track Changes” Thank you and best regards. Yours sincerely, 2023.11.2 Corresponding author: Name: Xu Zhang E-mail: 450047830@qq.com Attachments Attachment Submitted filename: Response to Reviewers-1.docx https://doi.org/10.1371/journal.pone.0295127.r004
16 Nov 2023 Decision Letter - Lalit Gupta, Editor Ultrasound-guided medial branch of the superior laryngeal nerve block to reduce peri-operative opioids dosage and accelerate patient recovery PONE-D-23-20292R2 Dear Dr. Zhang, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Lalit Gupta Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: All comments have been addressed Reviewer #3: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #2: Yes Reviewer #3: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: I Don't Know Reviewer #3: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #2: Yes Reviewer #3: No ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #2: Yes Reviewer #3: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: The revised manuscript greatly improves its quality, making it suitable for acceptance. The changes implemented enhance its coherence and clarity, significantly improving its overall readability and comprehension. Reviewer #3: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #2: Yes: LALIT GUPTA Reviewer #3: No ******** https://doi.org/10.1371/journal.pone.0295127.r005
Formally Accepted
30 Nov 2023 Acceptance Letter - Lalit Gupta, Editor PONE-D-23-20292R2 Ultrasound-guided medial branch of the superior laryngeal nerve block to reduce peri-operative opioids dosage and accelerate patient recovery Dear Dr. Zhang: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Lalit Gupta Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0295127.r006

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