Prehospital analgesia in adults using inhaled methoxyflurane

  title={Prehospital analgesia in adults using inhaled methoxyflurane},
  author={Paul G Buntine and Ogilvie Thom and Franz E. Babl and Michael J Bailey and Stephen Bernard},
  journal={Emergency Medicine Australasia},
Objective:  For many years, ambulance services throughout Australia have been administering methoxyflurane as a first‐line analgesic agent. However, there is a paucity of literature regarding its efficacy, safety and usage profile. The present study was designed to examine the efficacy of methoxyflurane in adults. 
The use of inhaled methoxyflurine as an analgesic in prehospital care
It has come to the attention of the Faculty of Pre-Hospital Care that methoxyflurine as an inhaler (Penthrox) is being used by doctors involved in various sports. We have particularly noted that it
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.
Stability of Methoxyflurane Loaded Penthrox Inhaler
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
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.
Comparison of inhalational methoxyflurane (Penthrox®) and intramuscular tramadol for prehospital analgesia.
For the doses of medication used in this implementation study, methoxyflurane was superior in efficacy, speed of onset and administration, but with more minor adverse effects when compared to IM tramadol.
Efficacy and safety of methoxyflurane: managing trauma associated pain in UK SAR helicopter paramedic practice
Penthrox appears to be a safe and efficacious analgesic when administered in analgesic dosages and the addition of an activated charcoal filter to the Penthrox inhaler renders the risk of occupational side effects negligible.
The Reincarnation of Methoxyflurane.
  • S. Ikeda
  • Medicine
    Journal of anesthesia history
  • 2020
A brief history of analgesia in paramedic practice
The history of analgesia in paramedic or ambulance practice in the United Kingdom and Australia is described in order to add to the knowledge base for this profession, and to inform the development of strategies to advance pain management practice.
Effectiveness of Prehospital Morphine, Fentanyl, and Methoxyflurane in Pediatric Patients
  • J. BendallPaul SimpsonP. Middleton
  • Medicine
    Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
  • 2011
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.
Effectiveness of Morphine, Fentanyl, and Methoxyflurane in the Prehospital Setting
Inhaled methoxyflurane, IN fentanyl, and IV morphine are all effective analgesic agents in the out-of-hospital setting and morphine appears to be more effective than IN fentanyl; however, the benefit of IV morphine may be offset to some degree by the ability to administer IN fentanyl without the need for IV access.


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
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.
Methoxyflurane analgesia for burns dressings: experience with the analgizer.
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.
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
Options in prehospital analgesia.
The present paper identifies the analgesia methods currently available in the prehospital setting so as to evaluate the various options and highlight areas for future research.
Prehospital identification and treatment of pain for patients with musculoskeletal trauma could be improved, and administration of analgesics to prehospital patients with suspected fractures was rare.
Controlled Sedation with Alphaxalone-Alphadolone
Alphaxalone-alphadolone (Althesin), diluted and administered as a controlled infusion, was used as a sedative for 30 patients in an intensive therapy unit and provided “light sleep,” allowed rapid variation in the level of sedation, and enabled repeated assessment of the central nervous system.
The need for better pre-hospital analgesia.
It is suggested that paramedics should be trained to administer intravenous opioid analgesia and there were wide variations in the attitudes of services around the country to future developments.
A New Anesthetic Machine and Technic With Particular Application to Developing Areas
Experience with 1334 T cases in whom the analgesia and light hypnosis normally provided by nitrous oxide during anesthesia was obtained by using low doses of methoxyflurane in a closed-circle system with a basal flow of 100 percent oxygen is described.
Acute pain is underassessed in out-of-hospital emergencies.
In most emergency patients the intensity of pain was underestimated by EMS, especially when pain was severe, and during the course of transport, both pain and pain assessment by EMS improved significantly.