Patient-Administered Pain-Killer Saves Time & Resources In Emergency Departments

Inhaled Analgesic Increases Speed Of Discharge Time Per Patient By 71 Minutes On Average Compared To Conventional Therapy

A recent study has revealed that Penthrox▼(methoxyflurane) can save more than one hour per procedure in hospital emergency departments on average — allowing more patients to be seen and potentially saving money for the NHS.1

Penthrox has been widely used in Australia and New Zealand for many years. However, it is used in fewer than half of UK emergency departments, mainly due to unfamiliarity with the treatment amongst staff.

Now researchers from St Mary’s Hospital, part of Imperial College Healthcare NHS Trust, have found that the non-opioid medicine, which is self-administered under the supervision of a person trained in its administration, can save 71 minutes on average in treating appropriate emergency department (ED) patients, compared to usual pain-killing techniques, with the added benefit of saving up to 50% on the cost of treatment per patient depending on the type of trauma injury.1

The results echo recent findings from other hospitals which show that patients treated with methoxyflurane spend significantly less time in ED compared to those treated with standard care.2,3

These results come at a time when the NHS is facing exceptional pressure and demonstrate how the use of Penthrox as a first-line analgesic for appropriate patients can free up resources including staff and equipment required to treat patients compared with standard treatments

Over the course of six months, the researchers, supported by A&E Consultant Dr George Bailey, looked at the length of stay in the Emergency Department for patients with moderate or severe trauma pain who received methoxyflurane compared with those who received standard care.1

Adult patients with moderate to severe trauma pain and Glasgow Coma Score of 15 were included in the evaluation.

Patients in both the methoxyflurane and standard care cohorts were matched for analytical purposes based on patient characteristics, including age group, gender and injury type, and previous medical history, in order to limit any potential for bias.

There were particular gains for patients suffering from a dislocated shoulder, where methoxyflurane patients saved over three hours in treatment time.1

The study, published today in the journal Advances in Therapy, also examined the different treatment costs and concluded that methoxyflurane may save up to 50% on the cost of treatment per patient, depending on the type of trauma injury.1

The researchers explained that Penthrox can negate the need for procedural sedation, which requires an intravenous line into the arm, a resus bed — which are often not immediately free — and also requires the time of three staff to carry out the procedure.

By contrast, Penthrox could be administered in a chair or on a trolley and only required one — two staff members depending on the procedure, as Penthrox is self-administered by the patient.

The researchers commented: “Long waiting times, slow discharge times and overcrowding are affecting almost every ED in the UK, and the situation does not show any signs of significant improvement at present.”

They concluded: “This evaluation demonstrated that the early use of methoxyflurane can positively impact length of stay within EDs and provide effective pain relief for patients.”

Commenting on the findings, Dr George Bailey said: “During our evaluation the use of Penthrox was well received by our staff and patients.’

“Being able to offer early fast-acting pain relief is essential and we were pleased to find the additional benefit of reducing time patients spent in the ED compared to standard care.”

Dr Dennise Broderick,
President & Managing Director,

Dr Dennise Broderick, Managing Director and President of Galen (who market Penthrox in the UK) added: “We all know the immense pressures facing trauma services in the UK, exacerbated in these exceptional circumstances.’

“We welcome these latest findings, which reinforce what has already been long accepted in other parts of the world — that Penthrox can help improve the throughput of patients in A&E departments by offering an effective means of pain control for patients that is simple to use and fast-acting.’

“We’re committed to providing education to help hospital teams make use of this particular innovation in the coming weeks and months.”

Penthrox consists of a green-coloured tube containing a fixed measure of methoxyflurane and can be self-administered by patients.

It can provide up to 60 minutes of pain relief per treatment.4

As a single-use product that requires no canisters, additional breathing masks or tubes and is disposed of after patient use via a sealable plastic bag, it greatly minimises the potential of inadvertently spreading infection across a department or between buildings.


  1. Young L, Bailey G, McKinley J. Service evaluation of methoxyflurane versus standard care for overall management of patients with pain due to injury. Adv Ther 2020.
  2. Umana E, et al.Inhaled methoxyflurane for the reduction of acute anterior shoulder dislocation in the emergency department. CJEM2019:21(4): 468-472
  3. Gangadharan L. Penthrox in the ED –is it worth the hype? Presented at The Royal College of Emergency Medicine Spring CPD meeting. April 2019
  4. Penthrox (methoxyflurane) Inhalation Product Information. December 2018
  5. Coffey F, Wright J, Hartshorn S et al. STOP!: a randomised, double-blind, placebo-controlled study of the efficacy and safety of methoxyflurane for the treatment of acute pain. Emerg Med J2014; 31(8):613–618.
  6. Mercadante S, Voza A, Serra S, et al. Analgesic Efficacy, Practicality and Safety of Inhaled Methoxyflurane Versus Standard Analgesic Treatment for Acute Trauma Pain in the Emergency Setting: A Randomised, Open-Label, Active-Controlled, Multicentre Trial in Italy (MEDITA). Adv Ther 2019; 36(11):3030-3046.
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