Effectiveness of inhaled methoxyflurane in acute pain in an emergency department – A systematic review of randomized controlled trials

Introduction

Inhaled Methoxyflurane has emerged as a popular analgesic agent for the management of acute traumatic pain in emergency settings. The aim of this review was to assess the analgesic efficacy of methoxyflurane compared to placebo and standard analgesics.

Methods

We performed a systematic review of the literature with searches of seven databases (Medline Complete, CINAHL Complete, OVID Emcare, Embase Classic + Embase, Cochrane Library, Scopus and Web of Science Core Collection) for randomized controlled trials where patients presented to the emergency department with acute traumatic pain and were administered inhaled methoxyflurane compared to placebo or standard analgesics. The primary outcome was the effectiveness of analgesia. Secondary outcomes were adverse events and patient and clinician satisfaction.

Results

The literature search produced 250 results, of which six met the eligibility criteria. All six studies reported improved pain scores with pain reduction of up to −30.392 mm on a 100 mm VAS scale and − 5.75 on an NRS 0–10 point scale for the methoxyflurane groups. All six studies concluded a shorter time to obtain pain relief for patients in the methoxyflurane groups. Patients and clinicians reported higher satisfaction in the methoxyflurane groups and there was a low incidence of adverse events.

Conclusion

Inhaled methoxyflurane provides rapid and effective pain relief for acute trauma, consistently outperforming placebo and standard treatments and improving patient and clinician satisfaction.