A pilot study of inhaled methoxyflurane for procedural analgesia in children

@article{Babl2007APS,
  title={A pilot study of inhaled methoxyflurane for procedural analgesia in children},
  author={Franz E. Babl and Peter L J Barnett and Greta M Palmer and Ed Oakley and Andrew J Davidson},
  journal={Pediatric Anesthesia},
  year={2007},
  volume={17}
}
Background:  Methoxyflurane (MF), a potent volatile anesthetic, can be used as an analgesic in subanesthetic concentrations. In Australia, MF is extensively used in children and adults as an analgesic in the prehospital setting via a hand‐held inhaler device. We conducted a pilot study to explore its use as a patient controlled analgesic for painful procedures in children in the emergency department (ED). 
Review article: Efficacy and safety of methoxyflurane analgesia in the emergency department and prehospital setting
TLDR
Despite the potential for renal impairment evident when methoxyflurane was used in anaesthetic doses, no significant adverse effects have been reported in the literature, neither in patients nor occupationally, when the dose used is limited to that currently recommended.
Stability of Methoxyflurane Loaded Penthrox Inhaler
TLDR
Methoxyflurane (MEOF), a non‐narcotic inhalational anaesthetic, administered with the Penthrox Inhaler is effective in managing acute pain, but its use in emergency departments and hospital wards has been limited.
Efficacy of inhaled methoxyflurane for procedural analgesia in paediatric burns: a pilot study
TLDR
Data showed that the incidence of hospitalised paediatric burn patients is highest in Africa, and in Sub-Saharan Africa, 83.6% of all burn injuries occurred in children between the ages 0–10.
The role of inhaled methoxyflurane in acute pain management
TLDR
Given the limitations of currently available analgesic agents in the prehospital and emergency department settings, the ease of use and portability of methoxyflurane combined with its rapid onset of effective pain relief and favorable safety profile make it a useful nonopioid option for pain management.
The use of methoxyflurane (Penthrox®) for procedural analgesia in the emergency department and pre-hospital environment
TLDR
Methoxyflurane is an efficacious analgesic agent in the emergency department and pre-hospital environment and performs favourably with a low chance of adverse events compared to other analgesic agents.
Effects of Penthrox (methoxyflurane) as an analgesic on cardiovascular and respiratory functions in the pre-hospital setting
Methoxyflurane (Penthrox) was initially introduced as an analgesic into Australian ambulance services in 1974. The last 40 years have seen it become extensively used in all government and
Efficacy and safety of inhaled low-dose methoxyflurane for acute paediatric pain: A systematic review
TLDR
In inhaled methoxyflurane has potential to provide easy to administer, needle-free analgesia with a rapid onset and good safety profile for paediatric acute moderate-to-severe pain.
The Reincarnation of Methoxyflurane.
  • S. Ikeda
  • Medicine
    Journal of anesthesia history
  • 2020
Methoxyflurane for Procedural Analgesia at 4470 m Altitude.
Effectiveness of Prehospital Morphine, Fentanyl, and Methoxyflurane in Pediatric Patients
  • J. Bendall, Paul Simpson, P. Middleton
  • Medicine
    Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
  • 2011
TLDR
Intranasal fentanyl and intravenous morphine are equally effective analgesic agents in pediatric patients with moderate to severe acute pain in the out-of-hospital setting and Methoxyflurane is less effective in comparison with both morphine and fentanyl, but is an effective opioid in the majority of children.
...
...

References

SHOWING 1-10 OF 29 REFERENCES
Inhaled methoxyflurane as a prehospital analgesic in children
Objective:  Despite widespread use of methoxyflurane as an inhaled analgesic by ambulance services in Australia there are no published data as to its use pattern, efficacy and safety in the
Methoxyflurane analgesia for burns dressings: experience with the analgizer.
TLDR
Methoxyflurane has been used to provide analgesia for burns dressings on sixty occasions in eleven patients by way of a new, disposable vaporizer, the Analgizer, which is described.
MethoxyfluraDe analgesia by Cyprane inhaler
TLDR
Good records showing the exact timing and amount of each dose, the blood pressure before and after the dose and the analgesic effect are essential where several persons may be involved in the treatment.
Hepatic and Renal Effects of Low Concentrations of Methoxyflurane in Exposed Delivery Ward Personnel
  • B. Dahlgren
  • Medicine
    Journal of occupational medicine. : official publication of the Industrial Medical Association
  • 1980
TLDR
Since definite alterations in the indices of both hepatic and renal functions were recognized in obstetrical personnel following exposure, a re-evaluation of the use of methoxyflurane for obstetrical analgesia is suggested.
Hepatic and renal effects of low concentrations of methoxyflurane in exposed delivery ward personnel.
TLDR
Since definite alterations in the indices of both hepatic and renal functions were recognized in obstetrical personnel following exposure, a re-evaluation of the use of methoxyflurane for obstetrical analgesia is suggested.
Methoxyflurane analgesia for burns dressings
The requirements for analgesia for burns dressings are discussed. Methoxyflurane has proved satisfactory in a clinical trial, and can be administered by one of two types of vaporizer. The possibility
Procedural sedation and analgesia in children
TLDR
The indications for PSA in children, the principles of providing safe and effective Sedation, including pre-sedation assessment and monitoring during sedation, adverse events related to sedation and pharmacology of commonly used drugs for sedation are reviewed.
Renal failure following methoxyflurane analgesia.
Two patients given methoxyflurane for analgesia over 14 and 16 days developed renal failure and died. The inhaler was withdrawn from the New Zealand market in 1984.
A comparison of prilocaine and lidocaine for intravenous regional anaesthesia for forearm fracture reduction in children
TLDR
In this prospective blinded randomized study, prilocaine and lidocaine were compared for intravenous regional anaesthesia for forearm fracture reduction in children.
Fluoride concentrations in urine of delivery ward personnel following exposure to low concentrations of methoxyflurane.
  • B. Dahlgren
  • Medicine
    Journal of occupational medicine. : official publication of the Industrial Medical Association
  • 1979
TLDR
There is a significant uptake of methoxyflurane by delivery ward personnel when this agent is employed for obstetrical analgesia, in spite of an apparently adequate system of environmental ventilation.
...
...