Pain management with methoxyflurane (Penthrox®) in Swedish ambulance care – An observational pilot study

Johansson, Anders; Svensson, Anders; Wihlborg, Jonas

doi:10.1016/j.ienj.2021.101076

Cited by 5 publications

(12 citation statements)

References 15 publications

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“…43,45,48 Two of these studies found no disparity between the genders, in turn affecting the reliability of the study conclusions. 45,48 The prospective study by Johansson et al 49 found, that females had a higher initial pain score, and when treated with the same analgesia methoxyflurane, had statistically significant lower pain scores at hospital in comparison to their male counterparts. This, as a single study, indicates that methoxyflurane may be more effective in reducing pain in females than in males.…”

Section: Discussionmentioning

confidence: 98%

“…Three of the included studies did comment on the analgesic management provided to patients being effective in reducing vNRS. 45,48,49 Only five studies explicitly identified confounding variables and subsequently controlled for them in their regression model. [38][39][40][41][42] From these, four found sex-specific disparities in analgesic administration.…”

Section: Discussionmentioning

confidence: 99%

“…Effect of pain score on analgesic administration and effectiveness. While the study by Johansson et al 49 did not comment on the difference in analgesic administration, it identified that females reported a higher vNRS for their pain at the beginning of a patient interaction and a statistically significant lower vNRS at hospital admission. Supples et al 40 and Lord et al 42 also reported on females having higher initial vNRS, whereas Lourens et al 47 was unable to find an association with pain score and sex.…”

Section: Summary Of the Studiesmentioning

confidence: 93%

“…The 13 included studies were conducted in ambulance services in multiple countries: USA (n = 5), [37][38][39][40][41] Australia (n = 3), [42][43][44] England (n = 1), 45 Italy (n = 1), 46 South Africa (n = 1), 47 Switzerland (n = 1) 48 and Sweden (n = 1). 49 All but one of the articles, 49 were conducted retrospectively, analysing data that had been routinely collected by an ambulance service as part of patient management. All the included studies analysed paramedic analgesic practices, with eight articles specifically investigating sex as a primary outcome.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All studies met the methodological quality rating threshold of 60% with four studies having a quality rating of 100%, 38,[40][41][42] seven having a quality rating of 75% 37,[43][44][45][46][47][48] and two having a quality rating of 62.5%. 39,49 All ROB scores are listed in Table 2.…”

Section: Risk Of Biasmentioning

confidence: 99%

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Influence of patient sex on pain management practices in Paramedicine: A rapid review

Dahoud,

Simpson,

Naidoo

2024

Paramedicine

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Objective: Pain is a subjective multidimensional experience that impacts an individual's physical, emotional, and mental wellbeing. Paramedics are regularly contacted to alleviate pain, in both an emergency and non-emergency capacity. Patient presentation, assessment tools, and clinical judgement, together influence paramedic decision making, and therefore pain management practices will inevitably vary. This research aimed to identify the nature and description of sex-specific discrepancies in the literature in relation to paramedic pain management. Methods: Using the Cochrane rapid review methodology, a search of five electronic databases and nine paramedic-specific journals was conducted on 8 November 2023. Articles were included if they: investigated ambulance presentations of pain; analysed pharmacological analgesic management; compared management between the sexes; and reported on either medication type, dosage, time to administration, or pain score. Eligible articles were assessed for risk of bias and subjected to narrative synthesis. Results: A total of 2545 articles were identified during the systematic search, resulting in 13 studies eligible for inclusion. Seven studies indicated a sex disparity in the administration of analgesia after controlling for confounders, with females statistically less likely to receive analgesia, particularly opioids, compared to males. Five studies found that sex had no effect on analgesic administration. One study noted female paramedics provided better analgesia overall, while two studies found paramedic sex had no influence on analgesic decisions. Five studies indicated that the higher the pain score, the greater the likelihood of analgesic administration, with three studies highlighting that the analgesia provided was effective in reducing pain score. Conclusions: While some studies identified no sex-specific differences in relation to paramedic pain management, a greater number of studies indicated a gender-disparity, where females were found to have higher risk of oligo-analgesia. Ideal pain management practices were demonstrated in the literature, with higher pain scores correlating to increased rates of analgesia.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Summary Of the Studiesmentioning

confidence: 93%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Biasmentioning

confidence: 99%

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Influence of patient sex on pain management practices in Paramedicine: A rapid review

Dahoud,

Simpson,

Naidoo

2024

Paramedicine

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Pain Management with Inhalation of Methoxyflurane Administrated by Non-Medical Ski Patrol: A Quality Assessment Study

Rydlöv,

Fjose,

Heyerdahl

2023

Pain Ther

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Introduction Pain management can be challenging, especially in remote locations where first responders are not certified health care personnel. In these settings, traditional intravenous administration of analgesics is not feasible. In this study, we explore the feasibility of using methoxyflurane as a first-line analgesic in ski-related traumas, administered by the ski patrol, acting as the municipality physician’s aiding personnel. Methods This is a quality assessment of a project aimed at improving pain management in trauma patients at the largest ski resort in Norway. Members of the ski patrol were trained and delegated administration of methoxyflurane on behalf of the municipality physician. Patients > 18 years with ski-related trauma and pain Numeric Rating Scale (NRS) of 6 or more were included. The patients received inhalational methoxyflurane on site, with continued administration during transport. Data were collected by the ski patrol and entered into a quality register. Results In total, 53 patients (18 to 76 years, 32 (60%) males) accepted to be registered. The injuries were fractures in 35 (66%), joint luxation in seven (13%), combination of fracture and luxation in seven (13%), and blunt soft tissue damage in four (8%) cases. Median NRS before administration of methoxyflurane was 8 decreasing to median NRS 5 after 5–10 min. The median NRS reduction of 3 (25–75% percentiles 2–5) was significant, p < 0.001. Patients rated the perceived effect as good in 40 (80%) moderate in nine (18%) and no effect in 1 (2%). Side effects were mild: Six patients (11%) experienced dizziness, one patient (2%) was considered drowsy. Conclusions Methoxyflurane is feasible as a first-line analgesic administered by a non-medical ski patrol in a responsibly organized system. Early pain management with inhalation of methoxyflurane provides good perceived effect with mild adverse events and can be of great value in settings where few alternatives for pain management are available.

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Ambulance nurses’ experiences of pain management with Penthrox® in Swedish ambulance care: A mixed method study

Wihlborg

Svensson

Ivarsson

et al. 2023

International Emergency Nursing

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Pain management with methoxyflurane (Penthrox®) in Swedish ambulance care – An observational pilot study

Cited by 5 publications

References 15 publications

Influence of patient sex on pain management practices in Paramedicine: A rapid review

Influence of patient sex on pain management practices in Paramedicine: A rapid review

Pain Management with Inhalation of Methoxyflurane Administrated by Non-Medical Ski Patrol: A Quality Assessment Study

Ambulance nurses’ experiences of pain management with Penthrox® in Swedish ambulance care: A mixed method study

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