Inhaled methoxyflurane and intranasal fentanyl for prehospital management of visceral pain in an Australian ambulance service

  title={Inhaled methoxyflurane and intranasal fentanyl for prehospital management of visceral pain in an Australian ambulance service},
  author={Steve Johnston and Garry J Wilkes and Jennifer A Thompson and Melanie R Ziman and Richard Brightwell},
  journal={Emergency Medicine Journal},
  pages={57 - 63}
Objective This study analysed the analgesic effect and changes in vital signs associated with administration of inhaled Methoxyflurane (MTX) and/or intranasal Fentanyl (INF) for prehospital management of visceral pain. Method A retrospective, observational study reviewing 1024 randomly selected records of patients with presumed visceral pain administered MTX (465), INF (397) or both (162) by the Western Australian Ambulance Service between January 2004 and February 2006. Clinical variables… 
Methoxyflurane in Non-Life-Threatening Traumatic Pain—A Retrospective Observational Study
A reduction in pain is shown, following methoxyflurane, similar to outcomes in other countries, as well as the attainment of a satisfactory level of pain reduction, according to paramedics, with the advantage of including patients in their own care.
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F Females and children are less likely to receive opiate-based analgesia than their male and adult counterparts, respectively, and Paramedics appear to favor intranasal opiate delivery over intravenous delivery in children with acute pain.
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Both low-dose methoxyflurane and N2O are suitable options for the pain treatment of trauma patients in the emergency setting and may not only offer advantages in emergency situations in remote or difficult-to-reach locations and mass-casualty situations but also be of significant value in urban and rural environments.
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A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting.
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Fentanyl citrate can be used safely andeffectively for pain management in the out-of-hospital arena and showed that fentanyl was effective in decreasing pain scores without causing significant hypotension, respiratory depression, hypoxemia, or sedation.
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Investigation of whether intranasal administration of fentanyl allows a demand-adapted postoperative opioid titration in patients who had undergone surgery for lumbar intervertebral disk protrusion found the pain reduction achieved was comparable in both groups.
Intranasal fentanyl titration for postoperative pain management in an unselected population
Intranasally administered fentanyl would appear to be suitable for the management of postoperative pain and pain intensities evaluated on a 101‐point numerical rating scale as well as on a verbal rating scale decreased significantly in both study groups within 5 min.
Intranasal fentanyl reduces acute pain in children in the emergency department: a safety and efficacy study.
Early and significant reduction in pain was achieved in children using intranasal fentanyl in the prehospital setting as well as a role for this form of analgesia as triage nurse-initiated administration in the emergency department.
Comparison of alfentanil and morphine in the prehospital treatment of patients with acute ischaemic-type chest pain
  • T. Silfvast, L. Saarnivaara
  • Medicine, Biology
    European journal of emergency medicine : official journal of the European Society for Emergency Medicine
  • 2001
Alfentanil is an effective analgesic in the prehospital treatment of myocardial ischaemic pain and was found to provide effective analgesia during the follow-up period of 15 minutes.
Review article: Efficacy and safety of methoxyflurane analgesia in the emergency department and prehospital setting
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.