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.
Highlights
Acute pain is a frequent symptom in prehospital care
Traumatic pain is usually treated with paracetamol [3], the equimolecular mixture of oxygen and nitrous oxide [4], ketamine [5], and opioids, such as morphine, fentanyl, or sufentanil [6,7,8,9]
The purpose of this study was to describe the characteristics of the patient population that received methoxyflurane for acute traumatic pain in the prehospital setting, its effect on the intensity of pain, and the satisfaction of prehospital care providers
Summary
Acute pain is a frequent symptom in prehospital care. Its prevalence reaches 42%, with 73% of patients receiving analgesics and approximately 50% experiencing an adequate reduction in pain [1,2]. In Switzerland, these analgesics can be administered by paramedics without direct physicians’ orders. Methoxyflurane is a halogenated derivative with strong analgesic properties at subanaesthetic doses [10,11]. It was recently approved in Switzerland for the treatment of moderate to severe traumatic pain in conscious adult patients. Convenient, lightweight, compact, single-use, and non-invasive, methoxyflurane has been considered an adjunct therapy to the primary treatment of pain in prehospital care [12]
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