Evidence map›Paper›PMID 40420189›Full record

ArticleTrials2025

Fentanyl or esketamine for traumatic pain (FORE-PAIN) trial: study protocol for a double-blind multi-arm randomized non-inferiority trial.

Midas N de Grunt, Nurseda Risvanoglu, Johannes A Siegers, Maurice A G M Kroon, Maruschka P Merkus, Markus W Hollmann, Milan L Ridderikhof, Robert P Weenink

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06051227 (Fentanyl or Esketamine for Traumatic PAIN), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

NCT06051227 phase3recruitingnot on this map

Fentanyl or Esketamine for Traumatic PAIN (FORE-PAIN) Trial

TypeinterventionalSponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)Ran2024 to 2026Enrolled608ConditionsAcute Pain Due to Trauma, Analgesia, Fentanyl, EsketamineArmsFentanyl Citrate, Esketamine
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
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

8 authors.

Midas N de GruntAmsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Nurseda RisvanogluAmsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Johannes A SiegersAmsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Maurice A G M KroonAmsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Maruschka P MerkusAmsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Markus W HollmannAmsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Milan L RidderikhofAmsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Robert P WeeninkAmsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. r.p.weenink@amsterdamumc.nl.ORCID http://orcid.org/0000-0003-3079-4115

Funding

Stichting Ziektekosten Verzekering Krijgsmacht 22-0024
6 · The paper itself

Abstract

backgroundAlthough fentanyl and esketamine, administered intravenously (IV) or intranasally (IN), are standard of care for treatment of acute traumatic pain in the prehospital setting in the Netherlands, comparative evidence regarding their efficacy and safety is lacking. Therefore, this study aims to assess the efficacy and safety of fentanyl IN, esketamine IV and esketamine IN as compared to fentanyl IV for management of acute traumatic pain in the prehospital setting.

methodsThis is a double-blind, monocenter, multi-arm, randomized non-inferiority trial in the prehospital setting in the Netherlands. Adult subjects receiving emergency care from Emergency Medical Services Ambulance Amsterdam and suffering from acute severe traumatic pain are randomized in an 1:1:1:1 ratio to receive fentanyl IV (1.0 µg/kg), fentanyl IN (1.25 µg/kg), esketamine IV (0.2 mg/kg), or esketamine IN (0.625 mg/kg). The primary endpoint is the reduction in Numeric Rating Scale (NRS, 0-10) score at 10 min after first administration of study medication. The prespecified non-inferiority margin is 1.0 for the between-group absolute difference in primary outcome. The primary endpoint is analyzed according to the intention-to-treat and per-protocol principles conforming to recommendations for non-inferiority analysis. Other endpoints include reduction in NRS score at other timepoints, need for additional analgesia, patient satisfaction, and adverse events. DISCUSSION: This trial is one of few double-blind randomized controlled trials in the prehospital setting and aims to answer questions that have relevance to prehospital practice. Research in a prehospital emergency setting also comes with challenges, including concerns about prehospital data quality, limited research experience among personnel and a limited timeframe for data collection and follow-up. Also, informed consent needs to be deferred.

trial registrationClinicalTrials.gov NCT06051227. Registered on 9 September 2023.

Indexed as

Acute PainAnalgesics, OpioidFentanylKetamineWounds and InjuriesAdministration, IntranasalAdministration, IntravenousAdultDouble-Blind MethodEmergency Medical ServicesEquivalence Trials as TopicHumansNetherlandsPain MeasurementRandomized Controlled Trials as TopicTreatment OutcomeAnalgesics, OpioidEsketamineFentanylKetamineAcute painAdministrationAnalgesiaEmergency medical servicesEsketamineFentanylIntranasalIntravenousWounds and injuries

Identifiers

PMID40420189
PMCPMC12105219

What OpenQuestion holds

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Registered trials

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.