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Role of Inhaled Methoxyflurane in the Management of Acute Trauma Pain

Authors Fabbri A, Ruggiano G, Garcia Collado S, Ricard-Hibon A, Restelli U, Sbrana G, Marinangeli F, Farina A, Coffey F

Received 3 March 2020

Accepted for publication 6 June 2020

Published 25 June 2020 Volume 2020:13 Pages 1547—1555


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael Schatman

Andrea Fabbri,1 Germana Ruggiano,2 Sergio Garcia Collado,3 Agnes Ricard-Hibon,4 Umberto Restelli,5,6 Giovanni Sbrana,7 Franco Marinangeli,8 Alberto Farina,9 Frank Coffey10

1Department of Emergency Medicine, Morgagni-Pierantoni Hospital, Forlì, Italy; 2Emergency Medicine Department, Santa Maria Annunziata Hospital, Florence, Italy; 3Hospital Recoletas Campo Grande, Valladolid, Spain; 4Service SAMU-SMUR-SAU, GHT Nord Ouest Vexin Val d’Oise, Pontoise 95, France; 5Center for Health Economics, Social and Health Care Management, LIUC - Università Cattaneo, Castellanza, VA, Italy; 6School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 7Anaesthesia, Intensive Care, Emergency Medicine, Grosseto HEMS, ASL Toscana Sud Est, Grosseto, Italy; 8Department of Anesthesiology and Intensive Care, University of L’Aquila, L’Aquila, Italy; 9Medical Affairs Department, Mundipharma Pharmaceuticals Srl, Milan, Italy; 10DREEAM - Department of Research and Education in Emergency Medicine Acute Medicine and Major Trauma, Nottingham University Hospitals’ NHS Trust, Nottingham, UK

Correspondence: Andrea Fabbri
Department of Emergency Medicine, Morgagni-Pierantoni Hospital, Via C. Forlanini 34, Forlì 47100, Italy
Tel +39 0543735156

Abstract: Adequate treatment of trauma pain is an integral part of the management of trauma patients, not just for ethical reasons but also because undertreated pain can lead to increased morbidities and worse long-term outcomes. Trauma pain management presents challenges in the pre-hospital setting, particularly in adverse or hostile environments as well as in busy emergency departments (EDs). Inhaled methoxyflurane, administered at analgesic doses via a disposable inhaler, has recently become available in Europe for the emergency treatment of moderate to severe pain in conscious adult trauma patients. A growing body of evidence demonstrates that inhaled methoxyflurane is well tolerated and effective in providing a rapid onset of analgesia. In this paper, we discuss the rationale for methoxyflurane use in trauma pain management, data from clinical trials recently conducted in Europe, its efficacy and safety profile compared to current standard treatments, its place in therapy and organizational impact. We conclude that inhaled methoxyflurane represents an effective treatment option in the different settings where trauma patients require rapid and flexible pain resolution, with potential organizational advantages.

Keywords: emergency, pre-hospital, analgesia, non-opioid pain management

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