Methoxyflurane in Non-Life-Threatening Traumatic Pain—A Retrospective Observational Study

Abstract

Pain management is a key issue in prehospital trauma. In Switzerland, paramedics have a large panel of analgesic options. Methoxyflurane was recently introduced into Switzerland, and the goal of this study was to describe both the effect of this medication and the satisfaction of its use. This was a retrospective cohort study, performed in one emergency ambulance service. It included adult patients with traumatic pain and a self-assessment of 3 or more on the visual analogue scale or verbal numerical rating scale. The primary outcome was the reduction in pain between the start of the care and the arrival at the hospital. Secondary outcomes included successful analgesia and staff satisfaction. From December 2018 to 4 June to October 2020, 263 patients were included in the study. Most patients had a low prehospital severity score. The median pain at arrival on site was 8 and the overall decrease in pain observed was 4.2 (95% CI 3.9–4.5). Regarding secondary outcomes, almost 60% had a successful analgesia, and over 70% of paramedics felt satisfied. This study shows a reduction in pain, following methoxyflurane, similar to outcomes in other countries, as well as the attainment of a satisfactory level of pain reduction, according to paramedics, with the advantage of including patients in their own care.

Paramedics in Switzerland: A Mature Profession

“…This allows them to acquire the methodological basis for publishing. Indeed, in recent years, paramedics have published in scientific journals on various topics such as the evolution of non-emergency care requests, on technical aspects during resuscitation or the treatment of pain [ 13 , 14 , 15 ]. Finally, the schools have developed this aspect of methodology considerably during the initial training.…”

Upper limb traumatic pain. Methoxyflurane versus standard treatment : a prospective study

“…Cette étude confirme que le méthoxyflurane permet une sédation de la douleur sans nécessiter de pose de voie veineuse. La généralisation de son usage en situation extrahospitalière pourrait être envisagée, de nombreuses voies veineuses étant souvent placées dans des conditions non confortables uniquement pour traiter une douleur d'origine traumatique 28 .…”