Penthrox (methoxyflurane) / Medical Developments International - LARVOL DELTA

Inhaled methoxyflurane for fracture reduction in prehospital extremity trauma: an observational review of HEMS clinical practice. (PubMed, Scand J Trauma Resusc Emerg Med) - "In this observational HEMS cohort selected for a trial of IMF, just over half of patients with acute traumatic limb injuries underwent prehospital manipulation and reduction without escalation to intravenous procedural sedation. Older age, pre-reduction analgesia, and patella injury were associated with success, but these findings are non-causal and should be interpreted cautiously."

Journal • Addiction (Opioid and Alcohol) • Anesthesia • Musculoskeletal Diseases • Orthopedics • Pain

PATIENT REPORTED EXPERIENCE OF BONE MARROW ASPIRATE AND TREPHINE BIOPSY. A NURSE LED SERVICE ESTABLISHMENT AND IMPROVEMENT PROJECT (EBMT 2026) - "This audit demonstrates that while overall satisfaction with BMAT is high, many patients continue to experience moderate–severe pain or significant anxiety. The findings support targeted refinements to nurse-led BMAT practice, including enhanced pre-procedure information, improved psychological support, and access to alternative analgesia for suitable patients. The SOP, competency framework, and preparatory governance work have established the foundations for a prospective evaluation of methoxyflurane for procedural pain management commencing January 2026."

Biopsy • Clinical • Hematological Disorders • Mood Disorders

APHP 180610: MAMI Use of the Methoxyflurane as pain-killer in the prehospital management of Acute Myocardial Infarction (clinicaltrialsregister.eu) - P2/3 | N=700 | Not yet recruiting | Sponsor: Assistance Publique Hopitaux De Paris

New P2/3 trial • Cardiovascular • Myocardial Infarction • Pain

Patient and Staff Satisfaction With Use of Methoxyflurane in the Emergency Department. (PubMed, Emerg Med Australas) - "With a specific focus on patient and clinician experience for acute, short-term pain, methoxyflurane is a well-received and effective option for analgesia in the ED."

Journal • Pain

Pain-Free TRUS B: A phase 3 double-blind placebo-controlled randomized trial of methoxyflurane with periprostatic local anaesthesia to reduce the discomfort of transrectal ultrasound-guided prostate biopsy (ANZUP 1501). (PubMed, BJU Int) - "We found no evidence that methoxyflurane improved pain scores at 15 minutes, however improvements were seen in patient-reported discomfort, overall experience, and willingness to undergo repeat biopsies."

Clinical • Journal • P3 data • Anesthesia • Oncology • Pain • Prostate Cancer • Urology

MetoksyKval: the extent of pre-hospital methoxyflurane administration for acute traumatic pain: focus on economic impact and rationale for use. (PubMed, Scand J Trauma Resusc Emerg Med) - "Methoxyflurane was viewed as a useful non-intravenous option in settings where rapid analgesia is essential. Although used in only 7% of patients with moderate to severe pain and associated with higher costs, it provided fast pain relief in patients with difficult venous access and when minimising on-scene time was critical. These results support its role as a bridge to longer-acting intravenous analgesia and may help decision-makers identify patient groups most likely to benefit, enabling more targeted and cost-effective implementation."

HEOR • Journal • Musculoskeletal Diseases • Orthopedics • Pain

3 mL Inhaled Methoxyflurane for Intrauterine Device (IUD) Insertion (clinicaltrials.gov) - P4 | N=110 | Not yet recruiting | Sponsor: Women's College Hospital

New P4 trial • Long-acting Reversible Contraceptives

Methoxyflurane exposure in ambulances: a controlled laboratory study on paramedic safety. (PubMed, Regul Toxicol Pharmacol) - "This controlled study confirms methoxyflurane's safe use in ambulances with exposure well below safety thresholds. Ventilation minimizes potential risk(s), ensuring paramedic safety and uninterrupted pain management."

Journal • Pain

METHOXYFLURANE or Virtual Reality Headset vs Standard Analgesic Management for the Reduction of Anterior Shoulder Dislocation (HYPNOLUX) (clinicaltrials.gov) - P4 | N=150 | Recruiting | Sponsor: Centre Hospitalier Universitaire de Nice | Trial completion date: Feb 2025 ➔ Mar 2027 | Trial primary completion date: Nov 2024 ➔ Dec 2026

Trial completion date • Trial primary completion date • Pain

Comparison of inhalational methoxyflurane, intranasal fentanyl, and intravenous morphine for treatment of prehospital acute pain in Norway (PreMeFen): a randomised, non-inferiority, three-arm, phase 3 trial. (PubMed, Lancet) - P3 | "Inhalational methoxyflurane is non-inferior to intranasal fentanyl and intravenous morphine for acute pain management in the prehospital environment, assessed 10 min after administration. Inhalational methoxyflurane serves as a valuable non-intravenous alternative in the early phase of treatment and might bridge the gap to longer-acting analgesics."

Head-to-Head • Journal • P3 data • CNS Disorders • Depression • Pain • Psychiatry

Methoxyflurane: a promising non-intravenous, non-opioid analgesic. (PubMed, Lancet) - No abstract available

Journal • Pain

Analgesic efficacy of inhaled methoxyflurane during transforaminal epidural steroid injection for lumbar radiculopathy: a randomized, double-blind placebo-controlled trial. (PubMed, Asian Spine J) - "Patient satisfaction was significantly higher with methoxyflurane (96.67%) than with placebo. Inhaled methoxyflurane is a safe and effective analgesic for TFESI, offering significant procedural pain reduction and high patient satisfaction, while maintaining a favorable safety profile."

Clinical • Journal • Musculoskeletal Pain • Pain • Xerostomia

Treatment of acute trauma-related pain in children and adolescents with methoxyflurane (Penthrox®) compared to placebo (MAGPIE): A randomised clinical trial. (PubMed, Injury) - P3 | "In this pivotal placebo-controlled trial, methoxyflurane was efficacious for treatment of acute trauma-related pain in paediatrics, with a safety profile consistent with adults."

Journal • Pain • Pediatrics

Beyond the Common: Methoxyflurane as a Cause of Acute Liver Failure (ACG 2025) - "It reduces oligoanalgesia by overcoming barriers of other analgesics like nitrous oxide, ketamine, or opioids...Rare cases of severe hepatotoxicity include a 2010 report after sevoflurane use...This case underscores the importance of prompt recognition. Co-administration of Augmentin might have contributed, highlighting the need for clear medication guidance and strategies to reduce harm.Figure: Portal inflammationFigure: Macrovesicular steatosis"

Anesthesia • Cardiovascular • Gastrointestinal Disorder • Hematological Disorders • Hepatitis C • Hepatology • Inflammation • Liver Failure • Renal Disease

BET: methoxyflurane to facilitate reduction of anterior shoulder dislocation. (PubMed, Emerg Med J) - "The author, date, country of publication, study type, patient characteristics, relevant results and study weaknesses were tabulated. Our results suggest favourable outcomes with methoxyflurane, but a multicentre randomised trial is needed to fully address this clinical question."

Journal • Anesthesia

Sources of Discomfort and Treatment Strategies for Trauma Patients in the Pre-Hospital Setting-A Scoping Review. (PubMed, J Emerg Nurs) - "The findings underline the multidimensional nature of discomfort in prehospital trauma care and highlight effective interventions, including pharmacologic and complementary nonpharmacologic strategies. However, significant gaps remain regarding standardized assessment tools for non-pain-related discomforts and combined interventions. This review underscores the necessity for comprehensive management protocols and further research to optimize patient comfort and care outcomes in trauma settings."

Journal • Mood Disorders • Pain • Psychiatry

Methoxyflurane Instead of Morphine in Acute Coronary Syndrome Patients: Results of the Randomized Controlled METHANE-SIRIO 4 Study. (PubMed, Thromb Haemost) - "Significant differences in median serum concentrations of ticagrelor and its active metabolite were most pronounced between patients treated with ticagrelor and methoxyflurane versus ticagrelor and morphine.Co-administration of methoxyflurane in acute coronary syndrome patients allows for the avoidance of negative effects of morphine and has the additional effect of inhibiting platelet reactivity. Further randomized studies would be recommended to support these findings."

Journal • Acute Coronary Syndrome • Cardiovascular

Comparative analysis of pain control in high-resolution anoscopy Lidocaine versus Methoxyflurane (ESCP 2025) - "Conclusion No significant differences were found in pain levels between patients who received lidocaine and those who received methoxyflurane as anesthesia during high-resolution anoscopy (p = 0.486). This suggests that both anesthetic agents may be equivalent in terms of pain perception during this procedure"

Anal Carcinoma • Anesthesia • Pain • Solid Tumor

Randomized controlled trial comparing the effects of methoxyflurane and local anesthesia combination to local anesthesia alone in scrotal surgery. (PubMed, Can Urol Assoc J) - "Scrotal surgery under LA is well tolerated; however, inhaled methoxyflurane as an adjunct to LA is an effective means of reducing anxiety and further improving patient-reported experiences during scrotal urologic procedures."

Journal • Anesthesia • Pain • Psychiatry

Methoxyflurane for IUD Insertion and Endometrial Biopsy (clinicaltrials.gov) - P=N/A | N=174 | Recruiting | Sponsor: Mount Sinai Hospital, Canada

New trial • Long-acting Reversible Contraceptives

Rotational investigation of volatile anesthetics: Conformational equilibrium, molecular structure, and complex hyperfine interactions of methoxyflurane. (PubMed, J Chem Phys) - "A computational characterization using density functional theory [CAM-B3LYP-D3 (BJ)] complemented the experimental results. This work completes the rotational investigations on the conformational and structural panorama of the most important halogenated inhalational anesthetics, potentially enabling their monitoring through rotational spectroscopic fingerprints."

Journal • Anesthesia

Trial to Assess the Efficacy and Safety During Convective Radiofrequency Water Vapor Thermal Therapy (REZUM) for Benign Prostate Hyperplasia (clinicaltrials.gov) - P3 | N=48 | Not yet recruiting | Sponsor: University of Manitoba

Head-to-Head • New P3 trial • Anesthesia • Benign Prostatic Hyperplasia

PenthroxOTL: Penthrox in Otolaryngology (clinicaltrials.gov) - P=N/A | N=50 | Not yet recruiting | Sponsor: Sir Mortimer B. Davis - Jewish General Hospital

New trial • Anesthesia • Otorhinolaryngology

Effectiveness of Penthrox vs Placebo in Sinus Procedures, a Clinical Trial (clinicaltrials.gov) - P1/2 | N=100 | Recruiting | Sponsor: St. Paul's Hospital, Canada | Trial completion date: Jun 2025 ➔ Jun 2026 | Trial primary completion date: Apr 2025 ➔ Apr 2026

Trial completion date • Trial primary completion date • Otorhinolaryngology • Pain • Respiratory Diseases • Sinusitis

Out-of-hospital neck of femur injury: An eight-year observational analysis. (PubMed, Prehosp Emerg Care) - "According to adjusted analysis, increasing age (Adjusted Odds Ratio (AOR)=1.026, 95% Confidence Interval (CI): 1.021,1.031), paramedic attendance (relative to basic life support-trained personnel, AOR = 3.471 (95%CI 2.921,4.125)), increasing initial pain score (AOR = 1.705 (95%CI 1.665,1.747)), application of a splint (AOR = 1.272 (95%CI 1.147,1.411)) and analgesia administration including opioids and methoxyflurane were associated with clinically meaningful pain reduction...Although most patients with neck of femur fractures reported a clinically meaningful reduction in pain, 30.5% of patients reported moderate to severe pain upon conclusion of out-of-hospital treatment. Expansion of analgesic options available to basic life support-trained patient transport officers, and educating prehospital clinicians on the safety and efficacy of analgesics and splinting practices, represent future opportunities for improvement."

Journal • Musculoskeletal Diseases • Orthopedics • Pain