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

Autor: Amaia Etxebarria Gulías, Luis Santos, Mikel Rico Briñas, Olga González Peña, Isabel López Isidro, Roberto Rodríguez Alonso, Sergio García Collado, Antonio Cid Dorribo, Jorge Trigo Colina, Laura Ferrer Armengou, Claudio Bueno Marisca, Norma B. Sanz Cadenas, Paula Núñez Gaviño, Rosa Capilla Pueyo, Alberto M. Borobia, Elena Sánchez Fernández Linares, Jose Carlos Martínez Ávila, Patricia Wunderling Brüggenmann, Fátima Barcala del Caño, Aitor Odiaga Andicoechea, Wilkins Poy, Susana Traseira Lugilde, Emilio Montero Romero, Luis Amador Barcela, Maite Ayuso Aragonés, Maria Antonieta Alvarez, José Lázaro González, María Corell González, Ignacio Pérez Torres, Paula Molina Ávila, César Carballo Cardona, Pere Llorens Soriano, Cesáreo Fernández Alonso, Angela Garcia, Antonio J. Carcas Sansuán, Anselma Fernández Testa, María M. Jaén Cañadas, Javier del Castillo Nos, Lubna Dani, Manuel Ruiz, José Ramón Casal Codesido, Yale Tung Cheng, Pedro Mesa Rodríguez, Carmen del Arco Galán, Kristina García Lombardía, Jose Valle Cruz, María Arranz Betegón
Rok vydání: 2019
Předmět:
Zdroj: Dipòsit Digital de la UB
Universidad de Barcelona
ISSN: 1097-6760
Popis: 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.
Databáze: OpenAIRE
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