Ms Dominique White¹, Mr Seevakan Chidambaram¹, Dr Christopher Wearn², A/Prof Marcus  Wagstaff²

¹The University Of Adelaide, Adelaide, Australia, ²Royal Adelaide Hospital, Adelaide, Australia

Abstract:

Seevakan Chidambaram is a 5th year Medical Student and the Chair of the Adelaide University Surgical Society with an interest in Plastics and Reconstructive Surgery.

Purpose

Procedural analgesia for burn dressing changes often requires IV access, clinical expertise in dosage titration and anaesthetic support¹. There has been recent interest in the use of inhaled methoxyflurane as an alternative. The aim of this study was to systematically review the current literature regarding the effectiveness and side-effect profile of self-administered, inhaled methoxyflurane for procedural pain relief compared to placebo/standard of care (SOC) in patients with burns.

Methodology

A literature search was conducted in MEDLINE (OVID), Embase (OVID) and Cochrane CENTRAL databases in March 2022. The screening process was conducted using the Covidence tool by two independent reviewers, The protocol was reported using the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). The primary outcome was reduction in pain intensity using validated pain scales at different timepoints. Secondary outcome was incidence of adverse events following analgesic administration.

Results

The search yielded 758 articles and 5 studies (n=160) met inclusion criteria with 2 prospective studies comparing methoxyflurane (n=46) to SOC (n=46). Based on preliminary data from these 2 studies, the methoxyflurane group had lower pain scores, superior adverse effect profile and simplicity of use with self-titration of doses. Median/mean pain scores from all studies reported effective reduction in pain scores with methoxyflurane when comparing intra-procedure to post-procedure pain.

Conclusion

The consistency of results suggests that methoxyflurane is a safe and effective alternative to SOC for pain relief in burn dressing changes however with study limitation considered, further research with randomized control trials is essential to generate stronger evidence.

References

1. Wasiak, J., Mahar, P., Paul, E., Menezes, H., Spinks, A. and Cleland, H., 2012. Inhaled methoxyflurane for pain and anxiety relief during burn wound care procedures: an Australian case series. International Wound Journal, 11(1), pp.74-78.

Biography:

Dominique White is a 5th year Medical Student and a Adelaide University Medical Student Society Committee Member, with an interest in Plastics and Reconstructive Surgery.