Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Skin Therapy Lett. 2024 Sep;29(5):1-9.
Pain management is an important aspect of dermatologic procedures, which are typically performed on awake patients in outpatient settings. The first-line modalities for procedural analgesia during most dermatologic procedures are topical and injectable local anesthetics, such as lidocaine. However, in some medical and cosmetic dermatologic procedures, pain cannot be effectively managed with local anesthetics due to procedure-specific lack of efficacy, large treatment surface areas, high dosage requirements, allergies, or other contraindications. In these circumstances, methoxyflurane inhalers may be highly beneficial. Methoxyflurane (Penthrox®) has demonstrated efficacy for providing pain relief in randomized controlled trials in patients who presented to emergency departments with acute trauma-related pain, as well as in patients undergoing painful procedures for other medical indications. The limited side effect profile, ease of patient self-administration, rapid onset and quick resolution of central nervous system effects following cessation makes methoxyflurane an ideal choice for analgesia during outpatient dermatologic procedures. This review provides an overview of the supporting evidence for methoxyflurane inhalers and clinical commentary on potential indications for methoxyflurane use in dermatology.
疼痛管理是皮肤科手术的一个重要方面，这些手术通常在门诊环境下对清醒患者进行。大多数皮肤科手术中，局部麻醉药（如利多卡因）是作为一线的手术镇痛方法。然而，在某些医学和美容皮肤科手术中，由于特定程序的疗效不足、大面积治疗区域、高剂量要求、过敏或其他禁忌症，局部麻醉药无法有效管理疼痛。在这些情况下，甲氧氟烷吸入器可能非常有益。甲氧氟烷（戊烷脒）在随机对照试验中已被证明可有效缓解急性创伤相关疼痛患者以及因其他医疗指征而接受疼痛治疗的患者的疼痛。其有限的副作用谱、易于患者自我给药、中枢神经系统效应停止后迅速起效和快速消退，使甲氧氟烷成为门诊皮肤科手术中镇痛的理想选择。这篇综述概述了甲氧氟烷吸入器的支持证据，并就其在皮肤科的潜在用途进行了临床评论。
