INTRODUCTION: Inhaled Methoxyflurane has emerged as a popular analgesic agent for the management of acute traumatic pain in emergency settings. The aim of this review was to assess the analgesic efficacy of methoxyflurane compared to placebo and standard analgesics.
METHODS: We performed a systematic review of the literature with searches of seven databases (Medline Complete, CINAHL Complete, OVID Emcare, Embase Classic + Embase, Cochrane Library, Scopus and Web of Science Core Collection) for randomized controlled trials where patients presented to the emergency department with acute traumatic pain and were administered inhaled methoxyflurane compared to placebo or standard analgesics. The primary outcome was the effectiveness of analgesia. Secondary outcomes were adverse events and patient and clinician satisfaction.
RESULTS: The literature search produced 250 results, of which six met the eligibility criteria. All six studies reported improved pain scores with pain reduction of up to -30.392 mm on a 100 mm VAS scale and - 5.75 on an NRS 0-10 point scale for the methoxyflurane groups. All six studies concluded a shorter time to obtain pain relief for patients in the methoxyflurane groups. Patients and clinicians reported higher satisfaction in the methoxyflurane groups and there was a low incidence of adverse events.
CONCLUSION: Inhaled methoxyflurane provides rapid and effective pain relief for acute trauma, consistently outperforming placebo and standard treatments and improving patient and clinician satisfaction.
| Discipline Area | Score |
|---|---|
| Physician |  |
Physician rater
This meta-analysis shows the effectiveness and safety of inhaled methoxyflurane for analgesia in the emergency department in adolescents and adults.
Physician rater
This is useful information, however, in Paediatrics we are still limited by a lack of evidence for the efficacy of methoxyflurane. A question that arises is whether ethics committees would permit such studies in children younger than 18 yrs of age, especially because pharmacokinetics and pharmacodynamics might be different in younger children and highly dependent on body weight dosing.
Physician rater
Inhaled methoxyflurane can be an suitable alternative to traditional analgesics for managing acute traumatic pain in EDs due to its rapid onset, ease of administration, favourable safety profile, and high levels of satisfaction among patients.
, McMaster University