Use of methoxyflurane for paediatric patients in a regional burn service outpatient clinic

Abstract

Background: Procedural analgesia is essential for burn-injured patients. Ketamine is the cornerstone of many procedural analgesia protocols for children as it is safe and effective. However, it requires monitoring and the child may remain sedated for a number of hours. We sought an alternative analgesic option. Methoxyflurane is an inhalational analgesic with rapid onset of action for short term analgesia. There is little literature on the use of this drug in children in South Africa, particularly in burns patients. This paper describes our introduction of methoxyflurane into our procedural analgesia protocols for pain associated with dressing changes for paediatric burns. Methods: We performed a retrospective review of data from the burns database for a two-month period after the addition of methoxyflurane to the paediatric burn outpatient procedural analgesia protocol as the first line analgesia option. Results: Ninety-five children were reviewed in the clinic over the two-month period. Thirty patients did not require analgesia for their dressing changes. Methoxyflurane provided effective analgesia in 49/65 (75%) patients. Conclusion: This study has shown that methoxyflurane is a viable option for analgesia for burns dressing changes in a busy outpatient setting. It is an effective and safe alternative to ketamine. Further research is required into the use of methoxyflurane in other burns settings to clarify predictors of failure, ease of use and possible side effect profiles.