Topical sevofluran: a galenic experience.

Area of Science:

• Anesthesiology and Pain Management
• Wound Care and Regenerative Medicine
• Pharmacology and Drug Delivery

Background:

• Sevoflurane, an inhaled anesthetic, is being explored for off-label topical application in wound management.
• Complicated painful wounds present a significant challenge in patient care, often requiring multimodal analgesia.
• Existing treatments may have limitations in efficacy, safety, or patient compliance.

Purpose of the Study:

• To review the pioneering experience of using topical sevoflurane for home treatment of complicated painful wounds.
• To evaluate the analgesic, antimicrobial, and pro-healing efficacy of topical sevoflurane.
• To assess the safety profile and risk-benefit balance of this off-label application.

Main Methods:

• Retrospective analysis of over 70,000 applications of topical sevoflurane over seven years.
• Protocol approved for off-label use in a Spanish Pain Unit for home treatment of painful wounds.
• Development and evaluation of new formulations (gel, microspheres) for topical sevoflurane application.

Main Results:

• Rapid, intense, and sustained analgesia observed, leading to reduced systemic analgesic consumption and improved quality of life.
• Emerging evidence suggests antimicrobial and pro-healing properties of topical sevoflurane.
• Pruritus is the most common adverse effect, generally transient and well-tolerated; no systemic toxicity reported.

Conclusions:

• Topical sevoflurane demonstrates a favorable risk-benefit profile for managing complicated painful wounds.
• New formulations, such as gel and microspheres, enhance safety, efficacy, and ease of application while reducing occupational exposure.
• Further research into novel topical sevoflurane formulations holds significant promise for advanced wound care.