The ESPEAR Trial
Research type
Research Study
Full title
Erector Spinae Plane blocks for the Early Analgesia of Rib fractures in trauma: a multicentre pilot randomised controlled trial with feasibility and embedded qualitative assessment.
IRAS ID
299011
Contact name
David Hewson
Contact email
Sponsor organisation
Nottingham University Hospital
ISRCTN Number
ISRCTN49307616
Duration of Study in the UK
2 years, 5 months, 1 days
Research summary
We don’t have a perfect way to give people pain relief for broken ribs, but doctors try combinations of tablets, strong painkillers in the a drip, epidural injections and even surgery to help. Physiotherapy and careful nursing care is also really important to help people recover. But there is no perfect pain relief ’recipe’ that works for every person every time.\nThe purpose of this study is to test if a new method of pain relief - called an erector spinae plane (ESP) block - can help people with broken ribs get better pain relief and reduce their risk of getting chest problems as a result of their broken ribs. ESP blocks are injections, like an epidural, that are simple to do and suitable for almost everyone. We know they help people after operations but we don’t know if they can help with broken ribs. An ESP block involves injecting local anaesthetic into the back to numb nerves which supply the broken ribs. We want to know if performing an ESP block soon after someone has broken their ribs can improve their health during their hospital admission, specifically the pain they suffer and their risk of needing extra oxygen or having developing a chest infection.\nTo test ESP blocks properly we need to do a large clinical trial at lots of hospitals that care for people with broken ribs. Before we launch into such a big project it is important to ’test the water’ and make sure we design that trial properly and understand what problems we might encounter. This is called a feasibility study and is what is being proposed here. This feasibility study will run at three UK hospitals in Nottingham, Manchester and London, caring for people with broken ribs. We will see if adding an ESP block to the existing ’recipes’ for pain relief for broken ribs makes a difference to 50 people’s pain relief and risk of becoming more unwell. We will collect data (for example pain scores) and do interviews (with patients and local researchers) which will help us design a well thought-out large trial. If this feasibility study works, we will ask for NHS support for a larger trial within 12 months of finishing this project. This study is called a randomised controlled trial because we need to compare different treatments between groups of patients. To try and make sure the groups are the same to start with, each patient is put into a group by chance (randomly). The results are then compared. In this trial, there are two groups: people who receive an ESP block alongside other pain relief, and people who receive a placebo, or “dummy” ESP block alongside other pain relief. \n
REC name
South Central - Oxford B Research Ethics Committee
REC reference
22/SC/0005
Date of REC Opinion
23 Feb 2022
REC opinion
Further Information Favourable Opinion