Efficacy of Inhaled Methoxyflurane for Acute Trauma Pain Management: A Systematic Review and Meta-Analysis.
Ahmed Zubair Husain, Ahmed Saud M Alsahli, Abdullah Mohammed A Alghamdi et al.
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In 30 seconds
This systematic review and meta-analysis assessed inhaled methoxyflurane versus control analgesics for acute trauma-related pain, synthesizing seven randomized controlled trials involving 1585 participants. Methoxyflurane shortened time to first pain relief by a mean of 5.93 min (95% CI -6.86 to -5.00) and reduced rescue analgesia use (risk ratio 0.40, 95% CI 0.18-0.90). Pain scores also favored methoxyflurane at 5, 10, 15, and 20 min. Overall adverse events were comparable, although dizziness, drowsiness, and cough were more frequent with methoxyflurane.
Key findings
- Time to first pain relief was shorter with methoxyflurane: mean difference -5.93 min (95% CI -6.86 to -5.00; p < 0.00001; I 2 = 0%).
- Rescue analgesia was less often needed with methoxyflurane (risk ratio 0.40, 95% CI 0.18-0.90; p = 0.03).
- Pain intensity favored methoxyflurane at 5, 10, 15, and 20 min.
- Overall adverse events were comparable, but dizziness, drowsiness, and cough were more frequent with methoxyflurane.
Why it matters
Rapid pain relief and reduced need for rescue analgesia may be useful outcomes in emergency care for acute trauma. The review also highlights specific adverse events to weigh alongside the overall comparable adverse-event rates. Its findings provide comparative evidence across randomized trials, while the authors note that further trials are needed to clarify effectiveness across trauma populations and emergency settings.
What to keep in mind
The review included seven trials, and the authors call for further high-quality randomized trials to clarify comparative effectiveness across trauma populations and emergency care settings.