Pain is one of the most frequent patient-reported symptoms in emergency departments (EDs). Pain management could be very challenging, notably for patients that must wait in an ED waiting room. In such context, antalgic drugs that could be used are mainly oral medications with the paracetamol (acetaminophen), the non-steroidal anti-inflammatory drugs and the weak and strong opioid drugs as the main available options, depending on the degree of pain. Those commonly used painkillers, with oral administration, need a delay (approximatively 20 to 30 minutes) before the full analgesic effect could be observed. Methoxyflurane is a self-administered inhaled analgesic used for over 40 years in countries such as Australia. Methoxyflurane has a rapid onset of action, is well tolerated and is widely used for moderate to severe traumatic pain, with several trials that have investigated it efficacy in such indication. However, no data are available concerning the management of non-traumatic painful diseases. Thus, the aim of the open-label, multicenter, and two parallel-arms superiority PAIN-THROX randomized controlled trial is to assess how using self-administered inhaled Methoxyflurane could reduce the time to pain relief comparatively with oral analgesic medications for patients seeking in an ED for non-traumatic painful diseases and who could wait in an ED waiting room.
Inclusion Criteria:
Exclusion Criteria:
Age < 18 years
Contraindications to methoxyflurane as stated in the Summary of Product Characteristics:
Hypersensitivity to the active substance or to any other fluorinated anesthetic or to any excipient.
Hemodynamically unstable patient (SBP < 100 mmHg, DBP < 30 mmHg)
Patient having already received Methoxyflurane on the same day
Patient having taken analgesic treatment prior to emergency consultation within 4 hours of admission.
Pain ≤ 39 mm
Pregnant, breastfeeding.
Women of childbearing potential not using a highly effective method of contraception throughout the study. The absence of pregnancy must be confirmed by performing a pregnancy test. Patients who are unable to provide a urine sample at the time of inclusion will not be enrolled in the study.
Subject under legal protection
Patients currently within the exclusion period of another clinical trial.
mickael.soletchnik@gmail.com0247471014
analgesic management with Methoxyflurane as first-line treatment
Pain treatment according to the usual analgesic management protocol of the emergency department of the participating center.
a.delage@chu-tours.fr0247473933
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