ReviewCureus2026
Structured Analgesia Pathways, Including Nurse-Initiated Approaches, for Acute Pain in Emergency Departments: A Systematic Review and Meta-Analysis.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute pain is a common reason for emergency department (ED) attendance, yet delayed analgesia remains a persistent challenge in emergency care. Structured analgesia pathways, including nurse-initiated approaches, may reduce treatment delays by enabling earlier pain assessment and analgesic administration according to predefined criteria. This systematic review and meta-analysis evaluated the effects of structured analgesia pathways on acute pain management in ED settings, focusing on time to analgesia, pain reduction, analgesia administration, patient satisfaction, adverse events, and ED flow. A comprehensive database search was conducted, and eligible studies were independently screened, extracted, and appraised. Sixteen studies were included. The evidence base consisted mainly of non-randomized comparative studies, quality improvement projects, and implementation studies, and the review protocol was not prospectively registered. Meta-analysis supported a reduction in time to analgesia with structured pathways; however, results varied considerably across studies, while sensitivity analysis supported the same overall direction of effect. Overall, structured analgesia pathways were associated with earlier analgesic administration and improved pain management processes, particularly when treatment could begin at triage or before physician assessment. Findings for pain intensity, satisfaction, safety, and ED length of stay were generally favorable but less consistent because of differences in study design, outcome definitions, and reporting methods. Risk of bias was driven mainly by non-randomized implementation, residual confounding, and incomplete standardization of outcome reporting. These findings suggest that structured analgesia pathways may improve the timeliness and reliability of emergency pain management, although stronger comparative studies are needed to clarify their effects on patient-centered and system-level outcomes.
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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.