Format

Send to

Choose Destination

See 1 citation found by title matching your search:

Ann Emerg Med. 2020 Mar;75(3):315-328. doi: 10.1016/j.annemergmed.2019.07.028. Epub 2019 Oct 14.

Inhaled Methoxyflurane Provides Greater Analgesia and Faster Onset of Action Versus Standard Analgesia in Patients With Trauma Pain: InMEDIATE: A Randomized Controlled Trial in Emergency Departments.

Author information

1
Hospital Universitario La Paz, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid, Hospital La Paz Institute for Health Research, and Spanish Clinical Research Network, Madrid, Spain. Electronic address: alberto.borobia@salud.madrid.org.
2
Hospital Campo Grande, Valladolid, Spain.
3
Hospital Universitario La Paz, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid, Hospital La Paz Institute for Health Research, and Spanish Clinical Research Network, Madrid, Spain.
4
Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.
5
Hospital Clínico San Carlos, Madrid, Spain.
6
Hospital Virgen del Rocío, Seville, Spain.
7
Hospital General de Alicante, Alicante, Spain.
8
Hospital el Bierzo, Ponferrada, Spain.
9
Hospital de Viladecans, Barcelona, Spain.
10
Hospital Universitario Álvaro Cunqueiro, Vigo, Spain.
11
Hospital Gernika-Lumo, Gernika-Lumo, Spain.
12
Complejo Asistencial de Zamora, Zamora, Spain.
13
Hospital Monográfico Asepeyo de traumatología, cirugía y rehabilitación, Coslada, Spain.
14
SUMMA 112, Madrid, Spain.
15
Hospital Universitario de La Princesa, Madrid, Spain.
16
Mundipharma Pharmaceuticals S.L., Madrid, Spain.

Abstract

STUDY OBJECTIVE:

The objective of the InMEDIATE study was to evaluate the change in intensity of traumatic pain over the first 20 min in adult patients treated with methoxyflurane versus standard analgesic treatment in Spain. This the first randomized, active-controlled, multicenter trial of methoxyflurane in the emergency setting in Europe.

METHODS:

This was a randomized, controlled study that enrolled adult patients with acute moderate to severe (score ≥4 on the 11-point Numeric Rating Scale) trauma-associated pain in 14 Spanish emergency departments. Patients were randomized 1:1 to methoxyflurane (up to 2×3 mL) or standard analgesic treatment. Coprimary endpoints were the change from baseline in Numeric Rating Scale pain intensity score during the first 20 minutes of treatment and time to first pain relief.

RESULTS:

Three hundred five patients were randomized (methoxyflurane 156; standard analgesic treatment 149). Most patients in the standard analgesic treatment group (70%) received intravenous first-step analgesics and 9.4% of patients were treated with opioids. Mean decrease from baseline in Numeric Rating Scale pain intensity score was greater for methoxyflurane than standard analgesic treatment at all points, with a significant treatment difference overall up to 20 minutes (repeated-measures model 2.47 versus 1.39; treatment difference 1.00; 95% confidence interval 0.84 to 1.32). Median time to first pain relief was significantly shorter for methoxyflurane than standard analgesic treatment (3 versus 10 minutes). Methoxyflurane achieved better patient and clinician ratings for pain control and comfort of treatment than standard analgesic treatment and exceeded patient and clinician expectations of treatment in, respectively, 77% and 72% of cases compared with 38% and 19% for standard analgesic treatment.

CONCLUSION:

These results support consideration of methoxyflurane as a nonnarcotic, easy-to-administer, rapid-acting, first-line alternative to currently available analgesic treatments for trauma pain.

Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center