Effectiveness of Penthrox for Pain Management in Ambulatory Gynaecology Procedures during COVID-19
Experience of novel inhalation agent Penthrox
for MVA during COVID-19
Ideal agent for analgesia and anxiolysis?
Authors: Forster LS, Lord JM, Royal Cornwall Hospitals NHS Trust
What is Penthrox?
•
Penthrox (methoxyflurane) is an inhaled vapour
•
It has an excellent safety record and is widely used in pre-
hospital care
•
It is delivered by a single use inhaler costing ~£18
•
Analgesia is rapid and should occur within 6-10
inhalations
•
It is a more powerful analgesic than Entonox and
additionally has an anxiolytic action
•
It is therefore ideally suited to ambulatory gynaecology
procedures but there is very little evidence of its use in
gynaecology
Introduction
•
During the COVID-19 pandemic, manual vacuum aspiration
(MVA) using a paracervical local anaesthetic block became
the routine surgical solution for abortion care owing to
difficulties in accessing theatres
•
A different cohort required ambulatory procedures and
urgent changes were required to manage their potential
distress
•
Penthrox was offered from 26/3/20 using Chair’s action
through the medical director’s office while Trust
governance committees were suspended
•
Since then approval has been formally granted through the
normal governance routes
Methods
•
In this cohort analysis all women undergoing MVA were
invited to complete a service evaluation questionnaire
immediately after the procedure
•
All 22 patients receiving Penthrox in the evaluation
period were included
•
“No Penthrox” data is from women who had an MVA
prior to the introduction of Penthrox when Entonox was
offered
•
Data from the two cohorts was collated separately
Conclusions
Penthrox is effective in reducing pain in women having an
abortion under local anaesthesia:
•
Lower mean pain score
•
Lower rate of severe pain
•
Pain reported to be less than normal menstruation
•
More patients reporting experience “better than
expected” even though many in this group would have
previously opted for a general anaesthetic
Penthrox (methoxyflurane) has shown effectiveness in reducing pain and anxiety in women undergoing abortion procedures under local anaesthesia. This novel inhalation agent offers rapid analgesia and anxiolysis, with lower pain scores and high patient satisfaction reported. The study highlights its potential as an ideal agent for ambulatory gynaecology procedures, particularly in challenging circumstances like the COVID-19 pandemic.
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Presentation Transcript
rcht-logo Experience of novel inhalation agent Penthrox for MVA during COVID-19 Ideal agent for analgesia and anxiolysis? Authors: Forster LS, Lord JM, Royal Cornwall Hospitals NHS Trust
What is Penthrox? Penthrox (methoxyflurane) is an inhaled vapour It has an excellent safety record and is widely used in pre- hospital care It is delivered by a single use inhaler costing ~ 18 Analgesia is rapid and should occur within 6-10 inhalations It is a more powerful analgesic than Entonox and additionally has an anxiolytic action It is therefore ideally suited to ambulatory gynaecology procedures but there is very little evidence of its use in gynaecology
Introduction During the COVID-19 pandemic, manual vacuum aspiration (MVA) using a paracervical local anaesthetic block became the routine surgical solution for abortion care owing to difficulties in accessing theatres A different cohort required ambulatory procedures and urgent changes were required to manage their potential distress Penthrox was offered from 26/3/20 using Chair s action through the medical director s office while Trust governance committees were suspended Since then approval has been formally granted through the normal governance routes
Methods In this cohort analysis all women undergoing MVA were invited to complete a service evaluation questionnaire immediately after the procedure All 22 patients receiving Penthrox in the evaluation period were included No Penthrox data is from women who had an MVA prior to the introduction of Penthrox when Entonox was offered Data from the two cohorts was collated separately
Results Penthrox (+ paracervical block) No Penthrox (+ paracervical block +/- Entonox) Number 22 337 Mean pain score Severe pain ( 8/10) Minimal pain ( 2/10) 3.1 0% 36% 4.4 11% 22% Mean pain score from normal menstruation Severe pain from menstruation ( 8/10) 4.6 9% 4.4 7% Care rated as excellent 96% 96% Did you find the whole process better or worse than expected? Better/much better Much better 86% 71% 69% 43%
Conclusions Penthrox is effective in reducing pain in women having an abortion under local anaesthesia: Lower mean pain score Lower rate of severe pain Pain reported to be less than normal menstruation More patients reporting experience better than expected even though many in this group would have previously opted for a general anaesthetic
