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PENTHROX ™ - Methoxyflurane History and Experience in the Management of Pain

PENTHROX ™ - Methoxyflurane History and Experience in the Management of Pain. Clinical Need. Inherent need to offer patients analgesia for existing or potential pain Current options: Local anaesthetics, oral analgesics, narcotics and …. Clinical Need.

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PENTHROX ™ - Methoxyflurane History and Experience in the Management of Pain

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  1. PENTHROX™ - Methoxyflurane History and Experience in the Management of Pain

  2. Clinical Need • Inherent need to offer patients analgesia for existing or potential pain • Current options: • Local anaesthetics, oral analgesics, narcotics • and …

  3. Clinical Need • Current analgesic options may be less than ideal due to: • Limited efficacy • Inconvenient administration • Length of onset or duration of action • Adverse reactions (e.g., respiratory depression)

  4. Methoxyflurane • Originally a general anaesthetic agent • Now Contraindicated due to safety concerns with dose • Unique in producing powerful analgesic properties at verylow sub-anaesthetic concentrations • Currently indicated for trauma and minor surgical procedures • Needs NO pre-medication • or fasting

  5. Features of Methoxyflurane • Potent analgesic with rapid onset • (6 – 10 breaths) • Demonstrated cardiovascular and • respiratory stability • No significant adverse effects • Can be administered easily to patients • of virtually all ages

  6. Penthrox™ Inhaler • The Penthrox™ Inhaler is a tubular light-weight disposable inhaler device that features: • Internal wick (absorption matrix) • Dilutor hole enables two concentrations • One-way valve to prevent blow-back • 22mm mouthpiece – connects to face mask

  7. Use intermittently as needed, or just before planned possible painful stage during intervention Intermittent Usage of Methoxyflurane

  8. Best to empower the patient to self-administer intermittently Gentle assistance/direction as needed Patient may close eyes as they relax, rarely drowsy – easily roused Recovery is quick Assisting the Patient to Manage Pain

  9. Clinical Studies • The analgesic safety and efficacy of methoxyflurane has been evaluated in a variety of areas: • Pre-hospital • Emergency • Burns • Dental • Obstetrics • Aesthetic surgery

  10. Case Series (Buntine, 2007) • 83 adult patients receiving paramedical assistance and transport to urban teaching hospital • Age range = 17 to 95 years • Methoxyflurane administered via Penthrox™ Inhaler • Administration duration = median of 29 minutes • Indication included musculoskeletal injury, visceral pain and back pain

  11. Case Series (Buntine): Results Statistically significant reduction in pain scores compared with baseline (p < 0.0001)

  12. Case Series (Babl, 2006): • 105 paediatric patients receiving paramedical assistance and transport to tertiary children’s hospital • Age range = 15 months to 17 years • Methoxyflurane administered via Penthrox Inhaler • Administration duration = median of 20 minutes • No pre-medications, no food or fluid restrictions

  13. Case Series (Babl): Results • Methoxyflurane administration resulted in a 43.0% reduction in pain scores within 10 minutes • 88.5% of paramedics were satisfied to very satisfied with the level of patient analgesia • 87.0% of patients were satisfied to very satisfied with the level of analgesia • 96.9% of primary care providers and older patients would want to use Methoxyflurane again for pain control

  14. Clinical Poster (Wilkes and Oxer, 2007): • 17,344 patients receiving paramedical assistance and transport to hospital • Age range = 2 years to 95+ years • Methoxyflurane administered via Penthrox Inhaler = 13,313 patients • Fentanyl administered intra-nasally = 4,021 patients • No pre-medications, no food or fluid restrictions

  15. Clinical Poster (Wilkes and Oxer): Results • No significant side effects reported • Methoxyflurane particularly useful in children • Analgesia from methoxyflurane found to be equivalent to intra-nasal fentanyl

  16. Examples of Use – Ambulance and Rescue • Physical trauma • Domestic trauma • Motor vehicle accidents • Pain / injury • Mass casualty • Emergency rescue

  17. Hospital • Accident and emergency • Minor surgical procedures • Burns / wound management • Radiology • Oncology • Acute pain services

  18. First Response • Worksite injuries • Sporting injuries • Injuries at mass public • gatherings • Physical trauma • Mass Trauma • Remote Areas

  19. Methoxyflurane Use – Severe Burns • Patient with severe burns and excruciating pain – immersed in water to cool • Immediate relief from suffering • watch patient’s face • Clinical team can immediately treat patient

  20. Potential Population • Patients who may benefit include those: • In pain • Anxious • Pain intolerant • Dislike of needles or injections • Uncooperative • Preparing for a painful • procedure

  21. Summary Methoxyflurane has been clinically demonstrated over many years to be a safe and effective agent offering patients comfort and relief from pain

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