Penthrox in Otolaryngology

Inhaled Methoxyflurane for In-Office Procedures in Otolaryngology

Our objective is to explore the use of methoxyflurane anesthesia as an adjunct analgesic to local anesthesia during in-office otolaryngology procedures in a prospective pilot study. The main outcome of this study will be patient satisfaction with the medication and analgesia. Secondary outcomes will include level of sedation and analgesia, patient-reported post-procedural pain levels, and any reported adverse events.

Inclusion Criteria:

• All adult patients undergoing any of the following procedures with inhaled methoxyflurane as an adjunct to topical or local anesthesia:

  • Skin lesion excision or reconstruction
  • Fine or core needle aspiration biopsy
  • Mucosal biopsy
  • Laryngeal injection or biopsy
  • Myringotomy with or without tympanostomy tube insertion
  • Inferior turbinate reduction
  • Septal button insertion

Exclusion Criteria:

• Patient unable to complete the post-procedure questionnaire (either due to time constraints, neurocognitive impairment, etc.)

• Presence of any contraindications to inhaled methoxyfluorane per product monograph:

  • Patients less than 18 years of age
  • Pregnancy, intended pregnancy, or current breast-feeding
  • Inadequate patient understanding or lack of cooperation
  • Decreased level of consciousness or head injury
  • History of clinically significant renal impairment, e.g., reduced renal output
  • History of liver dysfunction following previous exposure to halogenated anesthetics
  • Current use of tetracycline antibiotics
  • Personal or genetic history of malignant hyperthermia
  • Muscular dystrophy