A inhaled analgesic 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, a new study reveals.

The non-opioid medicine methoxyflurane (Penthrox) is self-administered under the supervision of a person trained in its administration.

Researchers from St Mary’s Hospital, in London, part of Imperial College Healthcare NHS Trust, found that 71 minutes on average were saved 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.

Over the course of six months, the researchers, supported by A&E Consultant Dr George Bailey, looked at 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.

Being able to offer early fast acting pain relief is essential

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, 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.

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.”

The study 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. This is because it 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.

The researchers added: “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.

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