Evidence map›Paper›PMID 40465577›Full record

ArticlePloS one2025

Anxiolysis for laceration repair in children: study protocol for an open-label multicenter adaptive trial (ALICE).

Naveen Poonai, Vinolia Arthur-Hayward, Samina Ali, Vikram Sabhaney, Quynh Doan, Evelyne Trottier, Jocelyn Gravel, Nam Anh Tran, Maala Bhatt, Mohamed Eltorki and 6 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05383495 (Anxiolysis for Laceration Repair in Children), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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.

NCT05383495 phase3recruitingnot on this map

Anxiolysis for Laceration Repair in Children: A Multicenter Adaptive Randomized Trial

TypeinterventionalSponsorLondon Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sRan2023 to 2026Enrolled300ConditionsLaceration of Skin, Distress, EmotionalArmsDexmedetomidine, Midazolam Nasal Spray, Nitrous oxide
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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

16 authors.

Naveen PoonaiDepartment of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada.ORCID https://orcid.org/0000-0003-1540-0413
Vinolia Arthur-HaywardDepartment of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada.
Samina AliDepartment of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton.
Vikram SabhaneyDepartment of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Quynh DoanDepartment of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Evelyne TrottierDepartment of Paediatric Emergency Medicine, CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada.
Jocelyn GravelDepartment of Paediatric Emergency Medicine, CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada.ORCID https://orcid.org/0000-0001-5901-4990
Nam Anh TranDepartment of Biostatistics, McGill University, Montreal, Quebec, Canada.
Maala BhattDepartment of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
Mohamed EltorkiDepartments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID https://orcid.org/0000-0001-6978-0015
Jennifer Thull-FreedmanDepartments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID https://orcid.org/0000-0002-8367-7994
Julie LeungWomen and Children's Health Research Institute, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada.ORCID https://orcid.org/0000-0001-8939-4824
Darcy BeerDepartment of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
Arlene JiangChild Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0009-0000-3158-8650
Raju PoolacherlaDepartment of Anesthesia, Western University, London, Ontario, Canada.
Anna HeathChild Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLacerations are the most common traumatic reason for children to visit an emergency department (ED), accounting for almost half of all procedures performed. Children experience considerable distress during laceration repair, despite routine application of local anesthetic. Pharmacologic anxiolysis may mitigate the negative practice of forcefully restraining a child, however, evidence for the most effective agent is lacking. We aim to determine the most effective anxiolytic agent for laceration repair in children.

methodsThis is a multicentre, phase III, three-arm, adaptive, randomized, open-label, trial. We will include children 2-12 years with a single laceration requiring suture repair in the ED. Participants will be randomized to receive intranasal dexmedetomidine (IND) 3 mcg/kg, intranasal midazolam (INM) 0.4 mg/kg, or inhaled 50% nitrous oxide (N2O). The primary outcome is the weighted mean anxiolysis score using the Observational Scale of Behavioral Distress - Revised (OSBD-R) from initial positioning to tying of the last suture. Secondary outcomes include need for additional anxiolytic, need for physical restraint, adverse events (AEs), and delayed maladaptive behaviors. The primary analysis will be conducted by intention-to-treat. Results will report posterior means, standard deviations (SDs), and 95% high density posterior credible intervals for Total Distress Score on the OSBD-R. We will rank interventions based on the probability that an intervention is superior (Pbest) and the Surface Area Under the Cumulative Ranking Curve (SUCRA) to indicate relative anxiolytic efficacy. The mean difference in Total Distress Score and secondary outcomes will be estimated using Bayesian models. ETHICS AND DISSEMINATION: Ethics approval will be obtained from institutional review boards of the participating sites. Informed consent will be obtained from guardians of all participants in addition to assent from all participants. Study data will be submitted for publication.

trial registrationClinicaltrials.gov NCT05383495.

Indexed as

Anti-Anxiety AgentsAnxietyDexmedetomidineLacerationsAdaptive Clinical Trials as TopicAdministration, IntranasalChildChild, PreschoolClinical Trials, Phase III as TopicEmergency Service, HospitalFemaleHumansMaleMidazolamMulticenter Studies as TopicAnti-Anxiety AgentsDexmedetomidineMidazolam

Identifiers

PMID40465577
PMCPMC12136299

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

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 Socratic graph.