Pain reduction of topical sevoflurane vs intravenous opioids in pressure ulcers

Abstract

Recently, it has been reported that topical irrigations of liquid sevoflurane on the bed of painful wounds produce a rapid, intense, and lasting analgesic effect. In this paper, A cohort of 112 patients with painful pressure ulcers who were refractory to opioids (or who exhibited undesirable adverse events to them) was treated with topical sevoflurane as per local institutional policy. These patients were recruited from an intensive care unit for a period of 3 years. The main aim was to determine the effectiveness of topical sevoflurane in reducing the pain of PUs and reducing the ulcer area. Study findings are reported and discussed herein and suggest that sevoflurane is a viable and promising treatment option for PUs.

Cost-effectiveness analysis of domiciliary topical sevoflurane for painful leg ulcers

“…Regarding effectiveness, the probability of SEVOFLURANE being more effective was 100% for the base-case and for all sensitivity analyses, even under the worst scenario for this group. This finding strongly agrees with a growing body of literature on the great clinical effectiveness of topical sevoflurane for painful vascular ulcers and other wounds of different etiologies [ 9 – 21 ]. In a recent retrospective study with a similar design, intensive care patients suffering from painful pressure ulcers and experiencing adverse effects caused by opioids were prescribed topical sevoflurane; compared to opioids alone, the addition of sevoflurane yielded results in effectiveness similar to ours, as pain scores were significantly lower and opioid consumption was significantly reduced [ 21 ].…”

“…Sevoflurane is a well-known ether-derivative inhalational general anesthetic. In recent years, an emerging body of evidence has reported on the analgesic properties of sevoflurane when it is irrigated on the bed of painful leg ulcers [ 9 – 18 ] and wounds of several etiologies [ 19 – 21 ], making it an interesting new alternative for the treatment of leg ulcers.…”

Pain Management in Dermatology

“…There are no large-scale studies, just case reports and small prospective series. Its tolerance is good, with no systemic adverse effects, and only a few local adverse effects: erythema and a sensation of heat, burning, or pruritus [63, 64].…”

Clinical and histological safety assessment of repeated intra-articular sevoflurane injections into knee joints of Sprague-Dawley rats

“…13 Over the last 10 years, sevoflurane has been repurposed as a topical analgesic for the treatment of painful chronic wounds. [14][15][16][17] As a topical analgesic, the simple method of administration involves the irrigation of the wound bed with liquid sevoflurane, which provides a rapid, intense, and long-lasting analgesic effect. 18 This new technique seems to be safe to the skin, as no histological local adverse effects associated with topical use have been reported.…”