{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:17:50Z","timestamp":1792808270329,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T00:00:00Z","timestamp":1698537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The primary objective was to compare the analgesic efficacy of ultrasound\u2010guided erector spinae plane block (ESPB) with a sham procedure in adult patients presenting with rib fractures to the emergency department (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized controlled trial was conducted at an academic ED over a 17\u2010month period. Forty\u2010six adults with confirmed rib fractures and numeric rating score (NRS) greater than 4 were randomized to one of two treatment arms: ultrasound\u2010guided ESPB group or placebo (sham procedure). Intravenous opioids were prescribed as rescue analgesia when self\u2010reported pain scores were \u22654. The primary outcome measure, pain intensity reduction, was derived using the 11\u2010point NRS at six time points over 12\u2009h. Secondary outcome measures included the amount of rescue analgesia, in morphine equivalents, and the occurrence of adverse events. Two\u2010way repeated\u2010measures ANOVA was used to compare the trend in NRSs across the two arms. The association between the complications and intervention was explored using the Fisher's exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010six patients (23 in each arm) completed the study. There was no difference between treatment groups with respect to age, sex, vital signs, preenrollment analgesia, or baseline pain intensity. In comparing pain intensity during the study period, NRS scores at 30, 60, and 120\u2009min were significantly lower in the ESPB group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) during rest and deep inspiration. Moreover, patients in the ESPB group received lesser rescue analgesia than those in the sham group (10\u2009mg, IQR\u20092.5 vs. 20\u2009mg, IQR\u20095\u2009mg; <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.01). There was no difference in adverse events between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ultrasound\u2010guided ESPB resulted in significantly reduced pain intensity over the study period and reduced amount of rescue analgesia and had no discernible difference in adverse events when compared with a sham.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14820","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T14:15:11Z","timestamp":1697465711000},"page":"316-325","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Efficacy and safety of ultrasound\u2010guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A\u00a0randomized controlled trial"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8489-7473","authenticated-orcid":false,"given":"Swetha","family":"Ramesh","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine &amp; Trauma Jawaharlal Institute of Postgraduate Medical Education &amp; Research  Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2541-5769","authenticated-orcid":false,"given":"S. Manu","family":"Ayyan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine &amp; Trauma Jawaharlal Institute of Postgraduate Medical Education &amp; Research  Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3498-6392","authenticated-orcid":false,"given":"Durga Prasad","family":"Rath","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery Jawaharlal Institute of Postgraduate Medical Education &amp; Research  Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8547-2901","authenticated-orcid":false,"given":"Deepthy Melepurakkal","family":"Sadanandan","sequence":"additional","affiliation":[{"name":"Research Scientist and Biostatistician, Women's &amp; Children's Health Research Unit Jawaharlal Nehru Medical College of KLE Academy of Higher Education and Research (KAHER)  Puducherry 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