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cc by-nc-nd (c) American College of Emergency Physicians, 2020
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/173283

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

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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 2x3 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.

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BOROBIA, Alberto m., GARCÍA COLLADO, Sergio, CARBALLO CARDONA, César, CAPILLA PUEYO, Rosa, FERNÁNDEZ ALONSO, Cesáreo, PÉREZ TORRES, Ignacio, CORELL GONZÁLEZ, María, CASAL CODESIDO, José ramón, ARRANZ BETEGÓN, María, AMADOR BARCELA, Luis, ODIAGA ANDICOECHEA, Aitor, FERNÁNDEZ TESTA, Anselma, TRIGO COLINA, Jorge, CID DORRIBO, Antonio, ARCO GALÁN, Carmen del, MARTÍNEZ ÁVILA, Jose carlos, TRASEIRA LUGILDE, Susana, CARCAS SANSUÁN, Antonio j., InMEDIATE Investigators Group. 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. _Annals of Emergency Medicine_. 2020. Vol. 75, núm. 3, pàgs. 315-328. [consulta: 20 de gener de 2026]. [Disponible a: https://hdl.handle.net/2445/173283]

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