Effectiveness and costs of methoxyflurane for prehospital injury and trauma study presented at Trauma Care webinar

Prof Niro Siriwardena presented at last months Trauma Care webinar on ‘How effective and what is the cost of inhaled methoxyflurane compared to usual analgesia for prehospital injury and trauma?‘ Trauma Care was founded in 1996 to address the need for commonly agreed standards of best clinical practice in the management of trauma and to improve outcomes for trauma by establishing best practice through education, research and publishing for all emergency and prehospital clinicians. Around 1000 attended the event from the UK and all over the world.The study team included Dr Murray Smith, Senior Research Fellow in Health Economics and Econometrics at CaHRU who led the analysis, Dr Elise Rowan, Clinical Database Manager at CaHRU, Robert Spaight at East Midlands Ambulance Service NHS Trust (EMAS) and involved patients and staff at EMAS.

Methoxyflurane (Penthrox®; Galen Ltd) although widely as an inhalational analgesic in adults and children for over 40 years in Australia and New Zealand was more recently issued a European licence for emergency relief of moderate to severe pain in conscious adults with trauma pain. The presentation described the implementation and evaluation of methoxyflurane in EMAS using an observational design and statistical/econometric modelling to show the effect of methoxyflurane compared with usual analgesics such as Entonox, intravenous paracetamol or intravenous morphine taking into account patient age, sex, clinical condition, and initial pain score.

The study involved training 96 EMAS clinicians provided 520 doses of methoxyflurane which were then used over the following year for adults with trauma, in place of or in addition to usual analgesics. Methoxyflurane acted more three times more quickly than Entonox or intravenous paracetamol to reduce pain from severe (pain score 7-10) to moderate (pain score 4-6), and more than twice as quickly as intravenous morphine. Both paramedics and EMTs were able to implement the use of methoxyflurane. Clinician reported adverse effects minor and infrequent (6.7%) and benefits were achieved at higher cost. Study limitations related to observational data and methods. The study was conducted independently from the funder, Galen Ltd.

To see the webinar click here.

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