Le methoxyflurane : agent analgésique utile aux urgences ?

In Emergency departments, 60% of patients experience pain regardless of the reason for admission. In these patients, pain is insufficiently evaluated and/or treated. Since methoxyflurane has a rapid and prolonged action, it has been launched on the market for treatment of moderate to severe acute traumatic pain. Methoxyflurane is an inhaled anesthetic agent with a rapid analgesic effect at low concentrations. Side effects are frequent and mostly neurological (vertigo, headache, drowsiness). Serious adverse reactions associated with anesthetic doses (renal and hepatic toxicity) contraindicate its use in patients with a medical history of renal failure, diabetes mellitus or hepatocellular insufficiency, even when administered at analgesic doses. The lack of studies with a good level of evidence and/or comparison of methoxyflurane with other analgesics used in the same indication does not allow it to be positioned in emergency room pain management algorithms or recommended for large-scale use.