Inhaled methoxyflurane in patients with cancer: current applications and future directions.

Purpose of review: Diagnosis and management of patients with suspected or confirmed cancers often require procedures which can cause significant anxiety, discomfort and pain. While intravenous sedation and strong opioids are effective, they could be risky in frail cancer patients with multiple comorbidities. Inhaled methoxyflurane (IMF) (Penthrox®) has been utilised as an analgesic for moderate to severe trauma pain for decades in emergency departments. This review article evaluates the latest evidence for the use of IMF in cancer-related procedures.

Recent findings: IMF has been recently shown to be effective in reducing pain and discomfort in patients receiving transrectal ultrasound-guided prostate biopsy and removal of gynaecological brachytherapy applicators. Side effects of IMF are mild and transient. No recent report of severe toxicities such as cardiopulmonary suppression was observed.

Summary: IMF is a safe drug device combination that can reduce discomfort and improve treatment compliance with repeat procedures in cancer patients. Real-world studies should be performed to further evaluate its safety and quality of life in diverse cancer patient populations and guide patient selection.