Deployed Combat Use of Methoxyflurane for Analgesia

Area of Science:

• Military Medicine
• Pain Management
• Pharmacology

Background:

• The U.S. Military requires rapid, non-opioid pain relief for battlefield injuries.
• Existing options like morphine auto-injectors are unavailable, and alternatives present challenges.
• Methoxyflurane, a handheld inhaler anesthetic, is a potential solution for deployed forces.

Purpose of the Study:

• To evaluate the feasibility and usability of methoxyflurane for analgesia in deployed combat settings.
• To analyze methoxyflurane use within the Department of Defense Trauma Registry (DODTR).

Main Methods:

• Retrieved DODTR encounters from 2007-2023 with interventions within 72 hours.
• Analyzed 22 prehospital methoxyflurane administrations using descriptive statistics.
• Focused on casualties with documented methoxyflurane use in combat environments.

Main Results:

• 22 encounters documented methoxyflurane administration, primarily in partner forces (50%) and U.S. Military (27%).
• Most casualties (64%) sustained battle injuries, with explosives (46%) as the leading mechanism.
• Injuries commonly affected extremities (27%), with 23% receiving tourniquets; pain scores showed a median decrease of 3 points.

Conclusions:

• Methoxyflurane administration in deployed combat is feasible.
• Methoxyflurane demonstrates usability for providing analgesia in combat scenarios.
• This agent represents a viable option for battlefield pain management.