Inhaled methoxyflurane ‘effective, rapid treatment for trauma’

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Undertreated pain can lead to increased morbidities and worse long-term outcomes

Inhaled methoxyflurane represents an effective treatment option in the different settings where trauma patients require rapid and flexible pain resolution, with potential organisational advantages, research shows. Adequate treatment of trauma pain was an integral part of the management of trauma patients, not just for ethical reasons but also because undertreated pain can lead to increased morbidities and worse long-term outcomes, Fabbri et al noted in a study.

In their paper, the researchers discussed the rationale for methoxyflurane use in trauma pain management, the data from clinical trials recently conducted in Europe, its efficacy and safety profile compared to current standard treatments, its place in therapy and organisational impact.

Writing in June in the Journal of Pain Research (J Pain Res), they said trauma pain management presented challenges in the pre-hospital setting, particularly in adverse or hostile environments as well as in busy emergency departments (EDs).

One possible treatment was methoxyflurane, a highly volatile hydrocarbon which is administered through a portable inhaler. It has an effective and rapid analgesic effect and was indicated as an emergency treatment for moderate to severe pain in adult conscious patients with trauma and associated pain, investigators noted.

A growing body of evidence, they added, had demonstrated that it was well-tolerated and effective in providing a rapid onset of analgesia.

“Inhaled methoxyflurane, administered at analgesic doses via a disposable inhaler, has recently become available in Europe for the emergency treatment of moderate to severe pain in conscious adult trauma patients,” they wrote.

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“In the emergency setting, key advantages are represented by the easy handling of the formulation and the rapid onset of action.”

The active ingredient, liquid methoxyflurane, is contained in a 3ml vial and is administered through a disposable inhaler. The patient inhales methoxyflurane from the mouthpiece and exhales through an active carbon chamber connected to the device, so that bystanders are not exposed to the drug. Low dose methoxyflurane, researchers concluded, was a well-tolerated and effective option in the management of acute, moderate to severe trauma pain in adult patients.

“Its ease of use, portability and fast action make it particularly useful in all the situations where rapid analgesia is required, including pre-hospital/hostile environments where practicality is necessary,” they added.

J Pain Res, published online, doi: 10.2147/JPR.S252222.

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