Begin main content

Methoxyflurane in Pre-Hospital Settings: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines

Published on: November 9, 2018
Project Number: RC1038-000
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 for the management of moderate to severe pain associated with acute trauma and/or procedural pain in pre-hospital settings?
  2. What is the cost-effectiveness of methoxyflurane for the management of moderate to severe pain associated with acute trauma and/or procedural pain in pre-hospital settings?
  3. What are guidelines informing the use of methoxyflurane for the management of moderate to severe pain associated with acute trauma and/or procedural pain in pre-hospital settings?

Key Message

Two systematic reviews were identified regarding the use of inhaled methoxyflurane as an analgesia for pain in the pre-hospital setting; however, neither of the systematic reviews provided a summary statistic, thus it is difficult to determine the magnitude of benefits of this agent in this particular population. Two primary studies were identified, both of which were retrospective observational studies. One was a safety study and inhaled methoxyflurane appeared to be safe and well tolerated. The other study suggested it was less effective for pain relief in this setting when compared to intravenous morphine or intranasal fentanyl.No relevant cost-effectiveness studies or evidence-based guidelines were identified for the use of methoxyflurane for the management of moderate to severe pain associated with acute trauma and/or procedureal pain in pre-hospital setting; therefore, no conclusions can be made. Given the limited availability and low quality of evidence, the effectiveness and use of inhaled methoxyflurane in the pre-hospital setting remains uncertain.

Tags

anesthesia, pain management, analgesics, emergency medical services, methoxyflurane, Prehospital, pre-hospital, Penthrox