Managing acute pain with inhaled methoxyflurane in non-cancer patients: a review of the latest evidence

Author:

Patel Partha1,Al Aadah Carmen F.2,Al Aadah Lelia F.3,Wong Henry C.Y.4,Lee Shing Fung56,Alkhaifi Muna7,Finkelstein Joel8,Rivlin Leon9

Affiliation:

1. Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada

2. Department of Biomedical Science

3. Department of Arts and Science, University of Guelph, Ontario, Canada

4. Department of Oncology, Princess Margaret Hospital, Kowloon West Cluster, Hong Kong, SAR, China

5. Department of Radiation Oncology, National University Cancer Institute, Singapore

6. Yong Loo Lin School of Medicine, National University of Singapore, Singapore

7. Department of Family and Community Medicine, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

8. Division of Orthopaedics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

9. Department of Emergency Medicine, Humber River Health, Toronto, Ontario, Canada

Abstract

Purpose of the review Penthrox® (inhaled methoxyflurane, IMF) is an inhaled analgesic used for the treatment of moderate-to-severe acute pain. It has various advantages including the capacity for being self-administered in the presence of healthcare providers (HCPs), rapid onset and offset, and having documented evidence for minimal adverse events post-use. In a variety of non-oncological settings such as pre-hospital transport and minor outpatient procedures, amongst others, IMF has significantly reduced acute pain. As IMF has the capacity to provide appreciable pain relief but is not as widely used as other acute analgesics (i.e., opioids), this review of past and current literature hopes to explore the impact of inhaled IMF on patient outcomes, procedures where it could be used, and to inform readers about this compound. Recent findings In general, patients who used IMF had decreased pain, improved psychosocial factors (i.e., reduced anxiety, improved satisfaction), and minimal adverse events thereby being concluded as safe for use. Summary Future use in remote medical interventions such as military contexts, in emergency room settings, and administration under the supervision of first responders such as non-paramedic and non-HCPs further broadens the scope of settings where IMF can meaningfully be implemented.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference24 articles.

1. 45 Satisfaction of paramedics and patients in the use of methoxyflurane (Penthrox) for the treatment of pain;Karjanlahti;BMJ Open,2018

2. Inhaled methoxyflurane for pain and anxiety relief during burn wound care procedures: an Australian case series;Wasiak;Int Wound J,2014

3. The epidemiology of pain in children treated by paramedics;Lord;Emerg Med Australas,2016

4. Pitch-side acute severe pain management decisions in European elite football;Doheny;Int J Sports Med,2022

5. Clinical effectiveness and costs of pre-hospital inhaled methoxyflurane for acute pain in trauma in adults: non-randomized control group study;Siriwardena;Br Paramedic J,2021

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