Evidence map›Paper›PMID 38001541›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2023

Randomised controlled trial of analgesia for the management of acute severe pain from traumatic injury: study protocol for the paramedic analgesia comparing ketamine and morphine in trauma (PACKMaN).

F Michelet, M Smyth, R Lall, H Noordali, K Starr, L Berridge, J Yeung, G Fuller, S Petrou, A Walker and 4 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.5field-weighted citation impact, top 7% 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

7 citing papers in PubMed, 11 citations in OpenAlex.

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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

14 authors at 6 institutions in 1 country.

F MicheletWarwick Clinical Trials Unit, University of Warwick, Coventry, UK. Felix.Michelet@warwick.ac.uk.ORCID http://orcid.org/0009-0003-6903-7637
M SmythWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
R LallWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
H NoordaliWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
K StarrWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
L BerridgeWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
J YeungWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
G FullerSchool of Health and Related Research, University of Sheffield, Sheffield, UK.
S PetrouNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
A WalkerWest Midlands Ambulance Services NHS Trust, Brierley Hill, Dudley, UK.
J MarkYorkshire Ambulance Services NHS Trust, Wakefield, UK.
A CanawayWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
K KhanWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
G D PerkinsWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
University of Warwick · GBUniversity Hospitals Birmingham NHS Foundation Trust · GBEast Midlands Ambulance Service NHS Trust · GBUniversity of Oxford · GBUniversity of Sheffield · GBYorkshire Ambulance Service NHS Trust · GB

Funding

Health Technology Assessment Programme NIHR128086
6 · The paper itself

Abstract

backgroundPrehospital analgesia is often required after traumatic injury, currently morphine is the strongest parenteral analgesia routinely available for use by paramedics in the United Kingdom (UK) when treating patients with severe pain. This protocol describes a multi-centre, randomised, double blinded trial comparing the clinical and cost-effectiveness of ketamine and morphine for severe pain following acute traumatic injury.

methodsA two arm pragmatic, phase III trial working with two large NHS ambulance services, with an internal pilot. Participants will be randomised in equal numbers to either (1) morphine or (2) ketamine by IV/IO injection. We aim to recruit 446 participants over the age of 16 years old, with a self-reported pain score of 7 or above out of 10. Randomised participants will receive a maximum of 20 mg of morphine, or a maximum of 30 mg of ketamine, to manage their pain. The primary outcome will be the sum of pain intensity difference. Secondary outcomes measure the effectiveness of pain relief and overall patient experience from randomisation to arrival at hospital as well as monitoring the adverse events, resource use and cost-effectiveness outcomes. DISCUSSION: The PACKMAN study is the first UK clinical trial addressing the clinical and cost-effectiveness of ketamine and morphine in treating acute severe pain from traumatic injury treated by NHS paramedics. The findings will inform future clinical practice and provide insights into the effectiveness of ketamine as a prehospital analgesia.

trial registrationISRCTN, ISRCTN14124474. Registered 22 October 2020, https://www.isrctn.com/ISRCTN14124474.

Indexed as

Acute PainAnalgesiaKetamineAdolescentAnalgesics, OpioidDouble-Blind MethodHumansMorphineMulticenter Studies as TopicParamedicsPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicTreatment OutcomeAnalgesics, OpioidKetamineMorphineKetamineMorphinePrehospital analgesiaTraumatic injury

Identifiers

PMID38001541
PMCPMC10668487
OpenAlexW4388972046

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.