Evidence map›Paper›PMID 29229039›Full record

SynthesisDeutsches Arzteblatt international2017

Analgesia in Patients with Trauma in Emergency Medicine.

David Häske, Bernd W Böttiger, Bertil Bouillon, Matthias Fischer, Gernot Gaier, Bernhard Gliwitzky, Matthias Helm, Peter Hilbert-Carius, Björn Hossfeld, Christoph Meisner and 3 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Deutsches Arzteblatt international, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 2 pooled it
7.3field-weighted citation impact, top 3% of its field
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

32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Prehospital locoregional anesthesia: a case series.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025
    Article
  7. Article
  8. Observational
  9. Review
  10. Article
  11. Article
  12. Article
  13. Observational
  14. Article
  15. Observational
  16. Article
  17. Article
  18. Review
  19. Trauma and syncope: looking beyond the injury.Trauma surgery & acute care open · 2023
    Review
  20. Practice Patterns and Management Protocols in Trauma across Indian Settings: A Nationwide Cross-sectional Survey.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023
    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

13 authors at 9 institutions in 4 countries.

David HäskeFaculty of Medicine, University of Tübingen; Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne; Department of Orthopedics, Trauma Surgery, and Sports Injuries, Cologne Hospitals, University of Witten/Herdecke; Department of Anesthesiology, Surgical Intensive Care, Emergency Medicine, and Pain Therapy, Hospital am Eichert, ALB FILS Hospitals, Göppingen; Department of Anesthesiology and Surgical Intensive Care, Hospital am Steinenberg, Reutlingen; MegaMed GbR, Maikammer; Department of Anaesthesiology and Intensive Care Medicine, Section Emergency Medicine, Federal Armed Forces Hospital, Ulm, Germany; Department of Anesthesiology, Intensive Care, and Emergency Medicine, Bergmanns trost BG Hospital, Halle; Institute for Clinical Epidemiology and Applied Biometrics, University of Tübingen; Department of Medicine II - Cardiology, Angiology, Intensive Care, Hospital am Steinenberg, Reutlingen; Central Emergency Department, Leipzig University Hospital.
Bernd W Böttiger
Bertil Bouillon
Matthias Fischer
Gernot Gaier
Bernhard Gliwitzky
Matthias Helm
Peter Hilbert-Carius
Björn Hossfeld
Christoph Meisner
Benjamin Schempf
Arasch Wafaisade
Michael Bernhard
Kreiskliniken Reutlingen · DEAlb Fils Kliniken · DEArmed Forces Hospital · SABG Klinikum Bergmannstrost Halle · DELake Tanganyika Authority · BIUniversity Hospital Cologne · DEUniversity of Tübingen · DEWitten/Herdecke University · DEZimmer Biomet (Netherlands) · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSuitable analgesic drugs and techniques are needed for the acute care of the approximately 18 200-18 400 seriously injured patients in Germany each year.

methodsThis systematic review and meta-analysis of analgesia in trauma patients was carried out on the basis of randomized, controlled trials and observational studies. A systematic search of the literature over the 10-year period ending in February 2016 was carried out in the PubMed, Google Scholar, and Springer Link Library databases. Some of the considered trials and studies were included in a meta-analysis. Mean differences (MD) of pain reduction or pain outcome as measured on the Numeric Rating Scale were taken as a summarizing measure of treatment efficacy.

resultsOut of 685 studies, 41 studies were considered and 10 studies were included in the meta-analysis. Among the drugs and drug combinations studied, none was clearly superior to another with respect to pain relief. Neither fentanyl versus morphine (MD -0.10 with a 95% confidence interval of [-0.58; 0.39], p = 0.70) nor ketamine versus morphine (MD -1.27 [-3.71; 1.16], p = 0.31), or the combination of ketamine and morphine versus morphine alone (MD -1.23 [-2.29; -0.18], p = 0.02) showed clear superiority regarding analgesia.

conclusionKetamine, fentanyl, and morphine are suitable for analgesia in spontaneously breathing trauma patients. Fentanyl and ketamine have a rapid onset of action and a strong analgesic effect. Our quantitative meta-analysis revealed no evidence for the superiority of any of the three substances over the others. Suitable monitoring equipment, and expertise in emergency procedures are prerequisites for safe and effective analgesia by healthcare professionals..

Indexed as

Emergency MedicinePain MeasurementAnalgesiaAnalgesics, OpioidGermanyHumansObservational Studies as TopicPain ManagementAnalgesics, Opioid

Identifiers

PMID29229039
PMCPMC5730701
OpenAlexW2948835407

What OpenQuestion holds

Textmetadata
Read underepoch 390

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 OpenQuestion graph.