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Methoxyflurane for Acute Pain in the Emergency Department: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines

Last updated: August 31, 2018
Project Number: RC1006-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of methoxyflurane (Penthrox) for moderate to severe acute trauma and/or procedural pain in emergency department patients?
  2. What is the cost-effectiveness of methoxyflurane (Penthrox) for moderate to severe acute trauma and/or procedural pain in emergency department patients?
  3. What are guidelines informing the use of methoxyflurane (Penthrox) for moderate to severe acute trauma and/or procedural pain in emergency department patients?

Key Message

One randomized controlled trial was identified regarding the use of methoxyflurane for pain from minor to moderate trauma in the emergency department. Overall, the study was well conducted, with appropriate randomization and blinding, as well as clearly reported inclusion and exclusion criteria, intervention, and comparator. Methoxyflurane was effective for pain relief when compared with placebo, and adverse events were primarily mild and transient. No studies were identified that compared methoxyflurane to an active comparator such as an alternative analgesic; the effectiveness of methoxyflurane compared with existing analgesics in the emergency department is uncertain. Additionally, no evidence-based guidelines or cost-effectiveness studies were identified, so no conclusions can be made regarding guidance on use or comparative costs.