| Methoxyflurane |
Methoxyflurane is a volatile anaesthetic agent with good analgesic properties in concentrations that do not generally produce loss of consciousness. It is used to produce short-term analgesia and may be of use in acute trauma, patient transport, and wound dressing. Methoxyflurane can be self-administered, via inhaler or vaporiser, by conscious haemodynamically stable patients, under the supervision of personnel trained in its use. These devices are used by ambulance services to provide analgesia when intravenous access may not be attainable. However, as safer and more effective agents are available, the clinical use of methoxyflurane is limited. It should only be used where appropriate resuscitation facilities are available.
Like nitrous oxide, methoxyflurane can occasionally produce loss of consciousness, hypotension, and nausea and vomiting. There is an increased risk of renal toxicity with repeated dosing, related to accumulation of the fluoride ion, and it is contraindicated in patients with pre-existing renal disease. Methoxyflurane is a trigger for malignant hyperthermia and should be avoided in patients with known or suspected susceptibility to malignant hyperthermia. Not more than 6 mL of methoxyflurane should be administered in a 24-hour period.
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