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The use of inhaled Methoxyflurine as an analgesic in PreHospital Care
It has come to the attention of the Faculty of Pre-Hospital Care that the methoxyflurine as an inhaler (Penthrox) is being used by doctors involved in various sports. We have particularly noted that it has been promulgated in the Premier League and also within Mountain Rescue.
Methoxyflurine was withdrawn from the United Kingdom, the European Union and the United States some years ago due to the occurrence of renal failure in patients. As a result it no longer has a licence for use in the United Kingdom, the European Union or the United States.
It has been and continues to be used by the emergency services in Australia under very careful dose monitoring 1,2,3,4. Our research indicates that due to its high cost per dose other analgesics are being trialled, in particular intranasal fentanyl5.
We have been in discussions with the Royal College of Anaesthetists regarding its use and as a result we have adopted the following principle for our members.
“Methoxiflurine inhalers do not have a licence for use in the United Kingdom, the European Community or the United States. They should not be used in pre hospital care until such time as licences are given or as part of an ethically approved controlled trial”.
Dr R J Fairhurst FCEM. FIMC,RCS.ed
Chairman, Training and Standards Committee
Faculty of Pre-Hospital Care, Royal College of Surgeons, Edinburgh
1. Grindlay, J; Babl, Franz E, Efficacy and safety of methoxyflurane analgesia in the emergency department and prehospital setting. Emerg Med Australas; 2009 Feb; 21 (1): 4-11
2. Buntine P, Thom O, Babl F, Bailey M, Bernard S; Prehospital analgesia in adults using inhaled methoxyflurane. Emerg Med Australas; 2007 Dec;19(6):509-14.
3. Johnston, SN; Wilkes, GJ; Safety and efficacy of methoxyflurane and intranasal fentanyl for non-traumatic pain; JEPHC,2008 Sep; 6 (3).
4. Babil FE,Jamison SR, Spicer M, Bernard S: Inhaled methoxyflurane as a prehospital analgesic in children. Emerg Med Australas; 2006 March;18,375-381.
5. Bernard S; Personal Communication December 2009
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