Methoxyflurane: A Review in Trauma Pain

Area of Science:

• Pharmacology
• Emergency Medicine
• Pain Management

Background:

• Methoxyflurane (Penthrox) is a halogenated ether historically used as an anesthetic.
• It has a 30-year history of analgesic use in Australia and New Zealand.
• Approved in the UK and Europe for emergency trauma pain relief in conscious adults.

Purpose of the Study:

• To review the pharmacological properties of methoxyflurane.
• To evaluate its clinical efficacy and tolerability for trauma pain.
• To compare methoxyflurane with other analgesics in pre-hospital and emergency settings.

Main Methods:

• Review of pharmacological properties.
• Analysis of data from the phase III STOP! trial.
• Comparison with intramuscular tramadol in prospective studies.

Main Results:

• Methoxyflurane demonstrated rapid onset of analgesia and was effective for minor trauma pain.
• It was more effective than intramuscular tramadol for acute musculoskeletal and ankle injuries.
• Low analgesic doses were not associated with nephrotoxicity, unlike anesthetic doses.

Conclusions:

• Inhaled methoxyflurane offers advantages in non-invasive self-administration, ease of use, and rapid onset.
• It is a useful additional treatment option for trauma pain in pre-hospital and emergency settings.
• The safety profile at analgesic doses supports its use for moderate to severe trauma pain.