Evidence map›Paper›PMID 38977292›Full record

Trial reportEmergency medicine journal : EMJ2024

EASIER trial (Erector-spinAe analgeSia for hepatopancreaticobiliary pain In the Emergency Room): a single-centre open-label cohort-based randomised controlled trial analysing the efficacy of the ultrasound-guided erector-spinae plane block compared with intravenous morphine in the treatment of acute hepatopancreaticobiliary pain in the emergency department.

Sandeep Nathanael David, Vignesh Murali, Pradeep Daniel Kattumala, Kundavaram Paul Prabhakar Abhilash, Ajith Thomas, Sudipta Dhar Chowdury, Reka Karuppusami

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Emergency medicine journal : EMJ, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. 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

7 authors.

Sandeep Nathanael DavidDepartment of Emergency Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India sanada_124@yahoo.com.ORCID http://orcid.org/0000-0001-7817-5335
Vignesh MuraliDepartment of Emergency Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India.
Pradeep Daniel KattumalaDepartment of Emergency Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India.
Kundavaram Paul Prabhakar AbhilashDepartment of Emergency Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India.
Ajith ThomasDepartment of Clinical Gastroenterology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India.
Sudipta Dhar ChowduryDepartment of Clinical Gastroenterology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India.
Reka KaruppusamiDepartment of Biostatistics, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUltrasound-guided (USG) erector-spinae plane block (ESPB) may be better than intravenous opioids in treating acute hepatopancreaticobiliary (HPB) pain in the ED.

methodsThis open-label randomised controlled trial was conducted in the ED of a tertiary-care hospital between March and August 2023. All adult patients with severe HPB pain were recruited during times that a primary investigator was present. Unconsenting patients, numeric rating scale (NRS) ≤6, age ≤18 and ≥80 years, pregnant, unstable or with allergies to local anaesthetics or opioids were excluded. Patients in the intervention arm received bilateral USG ESPB with 0.2% ropivacaine at T7 level, by a trained ED consultant, and those in the control arm received 0.1 mg/kg intravenous morphine. Pain on a 10-point NRS was assessed by the investigators at presentation and at 1, 3, 5 and 10 hours after intervention by the treatment team, along with rescue analgesia requirements and patient satisfaction. Difference in NRS was analysed using analysis of co-variance (ANCOVA) and t-tests.

results70 participants were enrolled, 35 in each arm. Mean age was 40.4±13.2 years, mean NRS at presentation in the intervention arm was 8.0±0.9 and 7.6±0.6 in the control arm. NRS at 1 hour was significantly lower in the ESPB group (ANCOVA p<0.001). At 1, 3, 5 and 10 hours, reduction of NRS in the intervention arm (7±1.6, 6.7±1.9, 6.6±1.8, 6.1±1.9) was significantly greater than the control arm (4.4±2, 4.6±1.8, 3.7±2.2, 3.8±1.8) (t-test, p<0.001). Fewer patients receiving ESPB required rescue analgesia at 5 (t-test, p=0.031) and 10 hours (t-test, p=0.04). More patients were 'very satisfied' with ESPB compared with receiving only morphine at each time period (p<0.001).

conclusionESPB is a promising alternative to morphine in those with HPB pain. TRIAL REGISTRATION NUMBER: CTRI/2023/03/050595.

Indexed as

Analgesics, OpioidEmergency Service, HospitalMorphineNerve BlockUltrasonography, InterventionalAdministration, IntravenousAdultAgedAnesthetics, LocalFemaleHumansMaleMiddle AgedPain ManagementPain MeasurementParaspinal MusclesAnalgesics, OpioidAnesthetics, LocalMorphineRopivacaineanalgesiaemergency departmentpain managementrandomized controlled trialultrasonography

Identifiers

PMID38977292
PMCPMC11503039

What OpenQuestion holds

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LicenceCC BY-NC
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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 OpenQuestion graph.