{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T18:58:39Z","timestamp":1770145119241,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010398","name":"Metro South Health","doi-asserted-by":"publisher","award":["RSS_2023_102"],"award-info":[{"award-number":["RSS_2023_102"]}],"id":[{"id":"10.13039\/100010398","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001078","name":"Emergency Medicine Foundation Ltd","doi-asserted-by":"publisher","award":["EMEG\u2010030R38\u20102022\u2010TSAO"],"award-info":[{"award-number":["EMEG\u2010030R38\u20102022\u2010TSAO"]}],"id":[{"id":"10.13039\/501100001078","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the effectiveness of ultrasound\u2010guided supraclavicular block (UGSCB), performed by emergency physicians, for closed reduction of upper limb fractures or dislocations when compared with Bier block (BB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an open\u2010label, noninferiority randomised controlled trial. Adults aged \u2265\u200918\u2009years presenting to an urban district ED with distal radius and\/or ulnar fractures requiring emergent reduction were included. Patients were randomised to either UGSCB using 0.75% ropivacaine or BB using 0.5% lignocaine or 0.5% prilocaine, performed by emergency physicians. The primary outcome was patient\u2010reported maximal pain during closed reduction measured via a 10\u2009cm visual analogue scale (VAS), with a noninferiority margin of 2\u2009cm. Secondary outcomes included post\u2010reduction pain at 1\u2010h and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 78 patients with 39 per group. Intention\u2010to\u2010treat analysis showed that maximal pain during closed reduction following UGSCB was noninferior compared with that after BB (UGSCB: median 0.1\u2009cm, interquartile range [IQR] 0 to 2.1; BB: 0.6\u2009cm, IQR 0 to 3.3; difference in medians \u22120.5\u2009cm, 95% Confidence Interval [95% CI] \u22121.7 to 0.7\u2009cm; <jats:italic>p<\/jats:italic><jats:sub><jats:italic>noninferiority<\/jats:italic><\/jats:sub>\u2009&lt;\u20090.001). Pain at 1\u2010h post\u2010intervention was significantly lower in the UGSCB (difference in median \u22121.8\u2009cm, 95% CI \u22122.6 to \u22121.0). There were no between\u2010group differences in adverse events (Odds ratio 2.1; 95% CI 0.18 to 24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Emergency physician\u2010performed UGSCB provides safe and effective regional anaesthesia that was non\u2010inferior to BB for maximal pain during closed reduction, with the potential advantage of prolonged analgesia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.70069","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T10:46:59Z","timestamp":1749725219000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<scp>SUPraclavicular<\/scp> Block for Emergency Reduction of Upper Limb Injuries Versus Bier Block (<scp>SUPERB<\/scp>): An Open\u2010Label, Noninferiority Randomised Controlled Trial"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4418-5441","authenticated-orcid":false,"given":"Henry","family":"Tsao","sequence":"first","affiliation":[{"name":"Emergency Department Redland Hospital  Cleveland Australia"},{"name":"Faculty of Medicine The University of Queensland  Herston Australia"},{"name":"Sonography Innovation and Research Group (Sonar Group)  Southport Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Tang","sequence":"additional","affiliation":[{"name":"Emergency Department Redland Hospital  Cleveland Australia"},{"name":"Faculty of Medicine The University of Queensland  Herston Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Cureton","sequence":"additional","affiliation":[{"name":"Emergency Department Redland Hospital  Cleveland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Maskell","sequence":"additional","affiliation":[{"name":"Emergency Department Redland Hospital  Cleveland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Trembath","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Herston Australia"},{"name":"Department of Anaesthesia and Pain Management Queensland Children's Hospital  South Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Jones","sequence":"additional","affiliation":[{"name":"Sonography Innovation and Research Group (Sonar Group)  Southport Australia"},{"name":"Emergency Department Logan Hospital  Meadowbrook Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8579-445X","authenticated-orcid":false,"given":"Peter J.","family":"Snelling","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Herston Australia"},{"name":"Sonography Innovation and Research Group (Sonar Group)  Southport Australia"},{"name":"Department of Emergency Medicine Gold Coast University Hospital  Southport Australia"},{"name":"School of Medicine and Dentistry Griffith University  Southport Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-024-03697-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2005.023713"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janh.2018.10.007"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1994.tb126551.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.14.6.352"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2022.0116"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000963"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2023.11.013"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.15441\/ceem.23.035"},{"key":"e_1_2_10_11_1","article-title":"Comparison of Supraclavicular Regional Nerve Block Versus Infraclavicular Regional Nerve Block in Distal Radial Open Reduction and Internal Fixation: A Retrospective Case Series","volume":"14","author":"Kukreja P.","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_10_12_1","first-page":"757","article-title":"Supraclavicular Brachial Plexus Block for Upper Limb Fracture Fixation:A Comparison of Nerve Stimulation, Ultrasound\u2010Guided Technique and a Combination of Both Techniques","volume":"37","author":"Omoregbe O. R.","year":"2020","journal-title":"West African Journal of Medicine"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2000.01330.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-021-01499-z"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/IMCRJ.S207317"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199508000-00020"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-023-07403-z"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-11-32"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005989"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1098-7339(06)80053-2"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2005.01121.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsb.2006.10.002"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12875"},{"key":"e_1_2_10_24_1","unstructured":"Faculty of Pain Medicine The Australian and New Zealand College of Anaesthetists Opioid Calculator 2022 www.opioidcalculator.com.au."},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-024-08395-0"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14555"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2006.08.019"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.09.011"},{"key":"e_1_2_10_29_1","first-page":"178","article-title":"Effect of Dexmedetomidine With Ropivacaine in Supraclavicular Brachial Plexus Block","volume":"17","author":"Sharma S.","year":"2019","journal-title":"Kathmandu University Medical Journal (KUMJ)"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000210"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.21037\/jhmhp.2019.12.01"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.4097\/kja.21028"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199403000-00016"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000670"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000224"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2009.01.015"},{"key":"e_1_2_10_37_1","volume-title":"Curriculum: Fellowship of the Australasian College for Emergency Medicine","author":"Australasian College for Emergency Medicine","year":"2022"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T12:44:43Z","timestamp":1754916283000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":36,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/1742-6723.70069"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70069","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2025-03-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70069"}}