Evidence map›Paper›PMID 37254224›Full record

ArticleTrials2023

Ultrasound-guided supraclavicular block versus Bier block for emergency reduction of upper limb injuries: a protocol for an open-label, non-inferiority, randomised controlled trial.

Henry Tsao, Christopher Tang, Mark Trembath, Philip Jones, Peter J Snelling

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2023. 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
1.3field-weighted citation impact, top 21% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Trial
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

5 authors at 3 institutions in 1 country.

Henry TsaoEmergency Department, Redland Hospital, Cleveland, QLD, Australia. henry.tsao@health.qld.gov.au.ORCID http://orcid.org/0000-0003-4418-5441
Christopher TangEmergency Department, Redland Hospital, Cleveland, QLD, Australia.
Mark TrembathSchool of Medicine, The University of Queensland, Herston, QLD, Australia.
Philip JonesDepartment of Emergency Medicine, Gold Coast University Hospital, Southport, QLD, Australia.
Peter J SnellingSchool of Medicine, The University of Queensland, Herston, QLD, Australia.
The University of Queensland · AUGold Coast Hospital · AUGriffith University · AU

Funding

Emergency Medicine Foundation EMEG-030R38-2022-TSAOMetro South Health RSS_2023_102
6 · The paper itself

Abstract

backgroundClosed reduction of upper limb fractures and/or dislocations are common in the emergency department (ED), which involves physically re-aligning the injured part prior to immobilisation. As this is painful, numerous techniques are available to provide regional anaesthesia to ensure patient tolerance. A Bier block (BB) is typically performed as part of routine care. An alternative technique gaining interest in the ED is ultrasound-guided supraclavicular block (UGSCB), which involves injecting local anaesthetic around the brachial plexus at the supraclavicular fossa under ultrasound guidance. It is unclear whether UGSCB is effective and safe when performed in the ED.

methodsSUPERB (SUPraclavicular block for Emergency Reduction versus Bier block) is a prospective open-label, non-inferiority randomised controlled trial that compares the effectiveness of UGSCB versus BB for closed reduction of upper limb fractures and/or dislocations. Adult patients presenting with an upper limb fracture and/or dislocation that requires emergent closed reduction in the ED will be eligible. After screening, participants will be randomised to either UGSCB or BB. Once regional anaesthesia is obtained, closed reduction of the injured part will be performed and appropriately immobilised. The primary outcome is maximal pain experienced during closed reduction measured via a visual analogue scale (VAS). Secondary outcomes include baseline and post-reduction pain, patient satisfaction, total opioid requirement in ED, ED length of stay, adverse events and regional anaesthesia failure. DISCUSSION: Existing evidence suggests UGSCB is effective when performed in the operating theatre by trained anaesthetists. SUPERB will be the first randomised controlled trial to elucidate the effectiveness and safety of UGSCB in the ED. The findings have the potential to provide an alternative safe and effective option for the management of upper extremity emergencies in the ED.

trial registrationThis trial has been registered on 21 October 2022 with Australia and New Zealand Clinical Trials Registry (ACTRN12622001356752).

Indexed as

Anesthesia, ConductionFractures, BoneAdultEquivalence Trials as TopicHumansPainProspective StudiesRandomized Controlled Trials as TopicUltrasonography, InterventionalUpper ExtremityBier blockEmergency medicineNerve blockPainRandomised controlled trialRegional anaesthesiaSupraclavicular blockUltrasonographyUpper limb injury

Identifiers

PMID37254224
PMCPMC10230709
OpenAlexW4378782884

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.